The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Jul 2009
Review Meta AnalysisAntibiotics versus placebo or watchful waiting for acute otitis media: a meta-analysis of randomized controlled trials.
Recommendations on withholding antibiotics in children with acute otitis media (AOM) have been inadequately implemented in clinical practice. ⋯ Antibiotic treatment is associated with a more favourable clinical course in children with AOM, compared with placebo, and also compared with watchful waiting. However, safety issues and the rather small treatment effect difference render the consideration of additional factors necessary in relevant clinical decision making.
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J. Antimicrob. Chemother. · Jul 2009
ReviewNasal decolonization of Staphylococcus aureus with mupirocin: strengths, weaknesses and future prospects.
Staphylococcus aureus in the nose is a risk factor for endogenous staphylococcal infection. UK guidelines recommend the use of mupirocin for nasal decolonization in certain groups of patients colonized with methicillin-resistant S. aureus (MRSA). Mupirocin is effective at removing S. aureus from the nose over a few weeks, but relapses are common within several months. ⋯ There is no convincing evidence that mupirocin treatment reduces the incidence of surgical site infection. New antibiotics are needed to decolonize the nose because bacterial resistance to mupirocin is rising, and so it will become less effective. Furthermore, a more bactericidal antibiotic than mupirocin is needed, on the grounds that it might reduce the relapse rate, and so clear the patient of MRSA for a longer period of time than mupirocin.