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Antibiotic usage for necrotising enterocolitis in newborn infants

Necrotising enterocolitis (NEC) is a gastrointestinal disease that primarily affects premature infants. Infants who have developed NEC could rapidly become very sick, leading to various morbidities and even death. The cause of NEC is uncertain and possibly multifactorial, but an infectious agent is most commonly suspected. Various antibiotic combinations are commonly used as treatment in such infants. Certain antibiotic regimens could lead to drug side effects and even antibiotic resistance. The authors of this study reviewed the medical literature to ascertain the best antibiotic combination for the treatment of this condition. Four eligible studies were identified and only two of these studies were found to be suitable for analysis. Both these studies were performed before 1988. The two studies included 62 infants with NEC and compared one antibiotic regimen to another. There was no difference between the two groups. The authors concluded that there was insufficient evidence to recommend a particular antibiotic regimen for NEC.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antibiotics for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Meconium‐stained amniotic fluid (MSAF) is the result of waste material from the fetal colon passing into the mother's amniotic cavity. Its incidence increases in post‐term pregnancies. Pregnant women with MSAF are more likely to develop maternal complications including inflammation of the fetal membranes caused by a bacterial infection (chorioamnionitis), postpartum inflammation of the lining of the uterus (endometritis) and neonatal complications such as neonatal sepsis and the need for admission to a neonatal intensive care unit (NICU). Fetal stress or hypoxia may trigger gasping fetal respirations, which results in the aspiration of meconium.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotics for bronchiolitis in children under two years of age

We reviewed the evidence on the effect of antibiotics on clinical outcomes in children with bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Newer, third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis

Acute bacterial meningitis is a life‐threatening illness. Currently the evidence suggests that old and new antibiotics offer the same level of treatment. Bacteria which cause meningitis are often thought to be resistant to conventional (older) antibiotics, and so doctors often prescribe newer antibiotics (called third generation cephalosporins). Commencing treatment early is vitally important and the choice of antibiotic is often made without any knowledge of possible drug resistance. This review examined 19 studies with 1496 participants to see whether there is a difference in effectiveness between conventional and newer antibiotics. This review found no differences. Adverse effects in both approaches were similar, except for diarrhoea, which was more common in the cephalosporin group. Only three studies dealt with adults; the remaining studies recruited participants aged 15 years and younger. Therefore, we believe that the results probably pertain more to children. Conventional and newer antibiotics seem reasonable options for initial, immediate treatment. The choice may depend on availability, affordability and local policies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Intrapartum antibiotics for known maternal Group B streptococcal colonization

Women, men and children of all ages can be colonized with Group B streptococcus (GBS) bacteria without having any symptoms. Group B streptococcus are particularly found in the gastrointestinal tract, vagina and urethra. This is the situation in both developed and developing countries. About one in 2000 newborn babies have GBS bacterial infections, usually evident as respiratory disease, general sepsis, or meningitis within the first week. The baby contracts the infection from the mother during labor. Giving the mother an antibiotic directly into a vein during labor causes bacterial counts to fall rapidly, which suggests possible benefits but pregnant women need to be screened. Many countries have guidelines on screening for GBS in pregnancy and treatment with antibiotics. Some risk factors for an affected baby are preterm and low birthweight; prolonged labor; prolonged rupture of the membranes (more than 12 hours); severe changes in fetal heart rate during the first stage of labor; and gestational diabetes. Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug‐resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Oral antibiotics appear to be as effective as parenteral antibiotics in the treatment of severe pneumonia in children

Acute respiratory infection (including pneumonia) is one of the leading causes of morbidity and mortality in children under five years of age in developing countries. Antibiotics are needed when a bacterial infection is suspected. When children are hospitalised they often receive injectable antibiotics. This has disadvantages: pain, risk of other infections and cost. There are studies that show that oral antibiotics are effective when children are treated as outpatients. The objective of this review was to determine the effectiveness and safety of oral antibiotics compared to parenteral antibiotics in the treatment of pneumonia in children less than five years old. Oral therapy appears to be an effective and safe alternative to parenteral antibiotics in hospitalised children with severe pneumonia who do not have any serious signs or symptoms. There is currently insufficient evidence to determine the relative benefits and harms of oral antibiotics in children with severe pneumonia if serious signs and symptoms are present or in children with severe pneumonia associated with bacterial confirmation or lobar consolidation on chest X‐ray.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antibiotics for preventing meningococcal infections

Meningococcal disease is a contagious bacterial disease caused by the bacteria Neisseria meningitidis (N.meningitidis) with high fatality rates: up to 15% for infection of the central nervous system (meningitis) and up to 50% to 60% among patients with blood stream infection and shock; up to 15% of survivors are left with severe neurological deficits. People who have had close contact with someone who has a meningococcal infection and populations with known high carriage rates are offered antibiotics in order to eradicate the bacteria and thus prevent disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Different antibiotics for group A streptococcal pharyngitis

We wanted to know which antibiotic was more effective in treating sore throats caused by bacteria (group A beta‐haemolytic streptococci (GABHS)).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Different antibiotic regimens for treating pregnant women with bacteria in their urine and without symptoms of urinary tract infection

Between 5% and 10% of pregnant women have bacteria in their urine without symptoms of infection (asymptomatic bacteriuria). If left untreated, women may go on to develop serious complications such as kidney infection or preterm birth. In this review we looked at studies comparing different antibiotic treatments for asymptomatic bacteriuria to see which antibiotics or which course of the same antibiotics (shorter versus longer courses) were most effective for reducing infection. We also looked at side effects such as vomiting. The studies included in this review failed to demonstrate any newer antibiotic or regimen which would be better than the older antibiotics and the traditional regimen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Different antibiotics for community‐acquired pneumonia in otherwise healthy children younger than 18 years of age in hospital and outpatient settings

Pneumonia is the leading cause of mortality in children under five years of age. Most cases of community‐acquired pneumonia (CAP) in low‐income countries are caused by bacteria. This systematic review identified 29 randomised controlled trials from many different countries enrolling 14,188 children and comparing antibiotics for treatment of CAP in children. Most were single studies only.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antibiotic regimens for management of intraamniotic infection

Antibiotics are used to prevent life‐threatening complications for mother and baby when the amniotic fluid is infected, but it is not known which antibiotic is best.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antibiotics for common respiratory infections with unclear causes and undifferentiated symptoms in children up to five years of age

Common upper ARIs are a large and varied groups of infections. They occur in any part of the upper respiratory system, last for up to seven days and have a wide variety of causes. They may lead to complications such as ear, throat and sinus infections. More common in pre‐school children, they are the most frequent reason for parents to seek medical assistance. Furthermore, they are responsible for 75% of the total prescribed antibiotics in high‐income countries. One possible rationale for prescribing antibiotics is the wish to prevent bacterial complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Fluoroquinolones for treating enteric fever

Researchers in The Cochrane Collaboration conducted a review of the effect of fluoroquinolone antibiotics in people enteric fever. After searching for relevant studies, they identified 26 studies involving 3033 patients. Their findings are summarized below.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibiotic prophylaxis for surgical site infection in people undergoing liver transplantation

Benefits and harms of antibiotic prophylactic regimens for surgical site infection in people undergoing liver transplantation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Using antibiotics to treat intra‐amniotic infection in pregnant women

Review question: Cochrane authors reviewed available evidence from randomized controlled trials on the use of antibiotics for the treatment of pregnant women with intra‐amniotic infection (chorioamnionitis).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antibiotics to treat foot infections in people with diabetes

We reviewed the effects on resolution of infection and safety of antibiotics given orally or intravenously (directly into the blood system) in people with diabetes that have a foot infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Introducing salt solution into the womb (amnioinfusion) to reduce complications associated with pregnancy fluid and sac infection (chorioamnionitis)

Chrioamnionitis is an infection of the fluid and sac surrounding the baby in the womb. This is usually managed with antibiotics and by delivering the baby. An additional method suggested is to infuse a salt solution into the womb either via a needle through the mother's abdomen (transabdominal) or a catheter via the mother's vagina (transcervical). The theory is that this may have a beneficial flushing or diluting effect on the infecting organisms.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

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