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Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Antibiotics are very effective at clearing urinary tract infections in pregnancy, and complications are very rare.

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

Version: 2011

Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

The model suggested that a particular strategy (systematic antibiotics, antibiotic impregnated cement and conventional ventilation) would prevent many deep infections and save the NHS the most money

Health Technology Assessment - NIHR Journals Library.

Version: July 2016

Given the uncertainty surrounding efficacy and safety of antibiotic impregnated cement (AIC) in primary prophylaxis, and the consequent lack of clarity with regards to resource implications, this report will review the clinical and cost-effectiveness of AIC in primary hip and knee arthroplasty patients.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 25, 2015

The aim of this Cochrane Review was to find out if using antibiotics at the time of cataract surgery can prevent bacterial infection of the eye (endophthalmitis) after cataract surgery. Cochrane researchers collected and analyzed all relevant studies to answer this question and found five studies.

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

Version: 2017

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

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

The microbial causes of pneumonia vary according to its origin and the immune constitution of the patient. Pneumonia is classified into community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and pneumonia in the immunocompromised. The guideline development process is guided by its scope - published after stakeholder consultation. This guideline does not cover all aspects of pneumonia, but focuses on areas of uncertainty or variable practice and those considered of greatest clinical importance. Best practice guidance on the diagnosis and management of CAP and HAP is offered, based on systematic analysis of clinical and economic evidence with the aim of reducing mortality and morbidity from pneumonia and maximising resources.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: December 2014

This guideline covers bacterial meningitis and meningococcal septicaemia, focusing on management of these conditions in children and young people aged younger than 16 years in primary and secondary care, and using evidence of direct relevance to these age groups where available.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010

Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: October 2008

Infective endocarditis (IE) is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental and certain non-dental interventional procedures.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: March 2008

In the past 30–50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in health care. This change has contributed to uncertainty about the most appropriate and effective way to diagnose and treat UTI in children and whether or not investigations and follow-up are justified.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2007

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year.

World Health Organization.

Version: 2016

It is a requirement of the Children’s National Service Framework that all ill children should have access to high-quality, cost-effective, evidence-based care. Because it is difficult to evaluate the severity of the illness, there is a need for evidence-based guidance to inform healthcare professionals about how to judge whether a child who presents with a fever is likely to develop a serious illness. Healthcare professionals also need advice to support their decision on whether to observe the child, perform diagnostic tests, start treatment such as antibiotics or refer onwards for specialist care. The guidance should also include advice on the best ways to detect fever, the management of fever itself, and what to tell parents and carers who have made contact with healthcare services. The guidance should be applicable to primary and secondary care and should take account of the number of agencies that are involved in giving health care and giving advice to parents and carers. It is also important that parental preferences, as well as the child’s best interests in terms of health outcomes, should be taken into account when considering the various options for investigation and treatment.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: May 2013

Early-onset neonatal bacterial infection (infection with onset within 72 hours of birth) is a significant cause of mortality and morbidity in newborn babies. Parent organisations and the scientific literature report that there can be unnecessary delays in recognising and treating sick babies. In addition, concern about the possibility of early-onset neonatal infection is common. This concern is an important influence on the care given to pregnant women and newborn babies. There is wide variation in how the risk of early-onset neonatal infection is managed in healthy babies. The approach taken by the NHS needs to: prioritise the treatment of sick babies, minimise the impact of management pathways on healthy women and babies, use antibiotics wisely to avoid the development of resistance to antibiotics. These drivers have not always been addressed consistently in the NHS, and this guideline was commissioned to ensure they would be addressed in future.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2012

This guidance is a partial update of NICE clinical guideline 13 (published April 2004) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2011

This guideline reviews the evidence for the care of women who present with signs and symptoms of preterm labour and those who are scheduled to have a preterm birth. It also reviews how preterm birth can be optimally diagnosed in symptomatic women, given that many women thought to be in preterm labour when clinically assessed will not deliver preterm. Optimal diagnosis can facilitate transfer to a place where appropriate neonatal intensive care can be provided, a strategy known to improve rates of survival for the baby. Additional areas that will be covered by the guidance (such as information needs for women who presents with signs and symptoms of preterm labour) are outlined in the guideline scope.

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2015

Sepsis is a clinical syndrome caused by the body's immune and coagulation systems being switched on by an infection. Sepsis with shock is a life-threatening condition that is characterised by low blood pressure despite adequate fluid replacement, and organ dysfunction or failure. Sepsis is an important cause of death in people of all ages. Both a UK Parliamentary and Health Service Ombudsman enquiry (2013) and UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD, 2015) have recently highlighted sepsis as being a leading cause of avoidable death that kills more people than breast, bowel and prostate cancer combined.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016

The guideline covers adults and children (from birth) with lower urinary tract dysfunction resulting from neurological disease or injury.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: August 2012

Systematic Reviews in PubMed

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