The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Brad Spellberg - One of the best experts on this subject based on the ideXlab platform.
-
systemic Antibiotic Therapy for chronic osteomyelitis in adults
Clinical Infectious Diseases, 2012Co-Authors: Brad Spellberg, Benjamin A. LipskyAbstract:The standard recommendation for treating chronic osteomyelitis is 6 weeks of parenteral Antibiotic Therapy. However, oral Antibiotics are available that achieve adequate levels in bone, and there are now more published studies of oral than parenteral Antibiotic Therapy for patients with chronic osteomyelitis. Oral and parenteral therapies achieve similar cure rates; however, oral Therapy avoids risks associated with intravenous catheters and is generally less expensive, making it a reasonable choice for osteomyelitis caused by susceptible organisms. Addition of adjunctive rifampin to other Antibiotics may improve cure rates. The optimal duration of Therapy for chronic osteomyelitis remains uncertain. There is no evidence that Antibiotic Therapy for >4–6 weeks improves outcomes compared with shorter regimens. In view of concerns about encouraging Antibiotic resistance to unnecessarily prolonged treatment, defining the optimal route and duration of Antibiotic Therapy and the role of surgical debridement in treating chronic osteomyelitis are important, unmet needs.
Benjamin A. Lipsky - One of the best experts on this subject based on the ideXlab platform.
-
systemic Antibiotic Therapy for chronic osteomyelitis in adults
Clinical Infectious Diseases, 2012Co-Authors: Brad Spellberg, Benjamin A. LipskyAbstract:The standard recommendation for treating chronic osteomyelitis is 6 weeks of parenteral Antibiotic Therapy. However, oral Antibiotics are available that achieve adequate levels in bone, and there are now more published studies of oral than parenteral Antibiotic Therapy for patients with chronic osteomyelitis. Oral and parenteral therapies achieve similar cure rates; however, oral Therapy avoids risks associated with intravenous catheters and is generally less expensive, making it a reasonable choice for osteomyelitis caused by susceptible organisms. Addition of adjunctive rifampin to other Antibiotics may improve cure rates. The optimal duration of Therapy for chronic osteomyelitis remains uncertain. There is no evidence that Antibiotic Therapy for >4–6 weeks improves outcomes compared with shorter regimens. In view of concerns about encouraging Antibiotic resistance to unnecessarily prolonged treatment, defining the optimal route and duration of Antibiotic Therapy and the role of surgical debridement in treating chronic osteomyelitis are important, unmet needs.
Dileep N. Lobo - One of the best experts on this subject based on the ideXlab platform.
-
Antibiotic Therapy Versus Appendectomy for Acute Appendicitis: A Meta-Analysis
World Journal of Surgery, 2010Co-Authors: Krishna K. Varadhan, David J. Humes, Keith R. Neal, Dileep N. LoboAbstract:Background Antibiotic treatment has been shown to be effective in treating selected patients with acute appendicitis, and three randomized controlled trials (RCTs) have compared the efficacy of Antibiotic Therapy alone with that of surgery for acute appendicitis. The purpose of this meta-analysis of RCTs was to assess the outcomes with these two therapeutic modalities. Methods All RCTs comparing Antibiotic Therapy alone with surgery in patients over 18 years of age with suspected acute appendicitis were included. Patients with suspected perforated appendix or peritonitis, and those with an allergy to Antibiotics had been excluded in the RCTs. The outcome measures studied were complications, length of hospital stay, and readmissions. Results Meta-analysis of RCTs of Antibiotic Therapy versus surgery showed a trend toward a reduced risk of complications in the Antibiotic-treated group [RR (95%CI): 0.43 (0.16, 1.18) p = 0.10], without prolonging the length of hospital stay [mean difference (inverse variance, random, 95% CI): 0.11 (−0.22, 0.43) p = 0.53]. Of the 350 patients randomized to the Antibiotic group, 238 (68%) were treated successfully with Antibiotics alone and 38 (15%) were readmitted. The remaining 112 (32%) patients randomized to Antibiotic Therapy crossed over to surgery for a variety of reasons. At 1 year, 200 patients in the Antibiotic group remained asymptomatic. Conclusions This meta-analysis suggests that although Antibiotics may be used as primary treatment for selected patients with suspected uncomplicated appendicitis, this is unlikely to supersede appendectomy at present. Selection bias and crossover to surgery in the RCTs suggest that appendectomy is still the gold standard Therapy for acute appendicitis.
Fred G. Barker - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of prophylactic Antibiotic Therapy in spinal surgery: a meta-analysis.
Neurosurgery, 2002Co-Authors: Fred G. BarkerAbstract:OBJECTIVE There is considerable variation in practice regarding the use of prophylactic Antibiotic Therapy in spinal operations. To date, individual studies have not demonstrated a significant benefit for prophylactic Antibiotic Therapy in spinal operations.METHODS Systematic database searches for r
Krishna K. Varadhan - One of the best experts on this subject based on the ideXlab platform.
-
Antibiotic Therapy Versus Appendectomy for Acute Appendicitis: A Meta-Analysis
World Journal of Surgery, 2010Co-Authors: Krishna K. Varadhan, David J. Humes, Keith R. Neal, Dileep N. LoboAbstract:Background Antibiotic treatment has been shown to be effective in treating selected patients with acute appendicitis, and three randomized controlled trials (RCTs) have compared the efficacy of Antibiotic Therapy alone with that of surgery for acute appendicitis. The purpose of this meta-analysis of RCTs was to assess the outcomes with these two therapeutic modalities. Methods All RCTs comparing Antibiotic Therapy alone with surgery in patients over 18 years of age with suspected acute appendicitis were included. Patients with suspected perforated appendix or peritonitis, and those with an allergy to Antibiotics had been excluded in the RCTs. The outcome measures studied were complications, length of hospital stay, and readmissions. Results Meta-analysis of RCTs of Antibiotic Therapy versus surgery showed a trend toward a reduced risk of complications in the Antibiotic-treated group [RR (95%CI): 0.43 (0.16, 1.18) p = 0.10], without prolonging the length of hospital stay [mean difference (inverse variance, random, 95% CI): 0.11 (−0.22, 0.43) p = 0.53]. Of the 350 patients randomized to the Antibiotic group, 238 (68%) were treated successfully with Antibiotics alone and 38 (15%) were readmitted. The remaining 112 (32%) patients randomized to Antibiotic Therapy crossed over to surgery for a variety of reasons. At 1 year, 200 patients in the Antibiotic group remained asymptomatic. Conclusions This meta-analysis suggests that although Antibiotics may be used as primary treatment for selected patients with suspected uncomplicated appendicitis, this is unlikely to supersede appendectomy at present. Selection bias and crossover to surgery in the RCTs suggest that appendectomy is still the gold standard Therapy for acute appendicitis.