SynthesisBMC medicine2018
Resistance decay in individuals after antibiotic exposure in primary care: a systematic review and meta-analysis.
Synthesis in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Ceftazidime with avibactam for treating severe aerobic Gram-negative bacterial infections: technology evaluation to inform a novel subscription-style payment model.Health technology assessment (Winchester, England) · 2024Pooled it
- Cefiderocol for treating severe aerobic Gram-negative bacterial infections: technology evaluation to inform a novel subscription-style payment model.Health technology assessment (Winchester, England) · 2024Pooled it
- One Health Determinants ofInternational journal of molecular sciences · 2023Pooled it
- β-Lactam-Resistant Streptococcus pneumoniae Dynamics Following Treatment: A Dose-Response Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Transcript host-RNA signatures to discriminate bacterial and viral infections in febrile children.Pediatric research · 2022Pooled it
- Natural history of uncomplicated urinary tract infection without antibiotics: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- An analysis of reporting quality of prospective studies examining community antibiotic use and resistance.Trials · 2018Pooled it
- Trial
- Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Influence of a guideline or an additional rapid strep test on antibiotic prescriptions for sore throat: the cluster randomized controlled trial of HALS (Hals und Antibiotika Leitlinien Strategien).BMC primary care · 2023Trial
- Silk-based biomimetic nanocomposite for precision eradication of Helicobacter pylori and gut microbiome preservation.Journal of nanobiotechnology · 2026Article
- Global Prevalence, Temporal Trends, and Associated Mortality of Bacterial Infections in Patients with Liver Cirrhosis: A Meta-analysis.Journal of clinical and translational hepatology · 2025Article
- Effects of a Primary Care Antimicrobial Stewardship Program on Meticillin-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Epidemiology of antibiotic consumption and resistance in Mauritius.Frontiers in antibiotics · 2024Article
- Artificial Intelligence to Improve Antibiotic Prescribing: A Systematic Review.Antibiotics (Basel, Switzerland) · 2023Review
- Survey of Bacterial Isolates and Their Antimicrobial Susceptibility Patterns from Dogs with Infective Endocarditis.Pathogens (Basel, Switzerland) · 2023Article
- Multidrug Resistance ofOpen forum infectious diseases · 2023Article
- Systematic review of time lag between antibiotic use and rise of resistant pathogens among hospitalized adults in Europe.JAC-antimicrobial resistance · 2023Review
- Implementation of A Year-Long Antimicrobial Stewardship Program in A 227-Bed Community Hospital in Southern Italy.International journal of environmental research and public health · 2023Article
- Impact of a Primary Care Antimicrobial Stewardship Program on Bacterial Resistance Control and Ecological Imprint in Urinary Tract Infections.Antibiotics (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAntibiotic resistance is an urgent global problem, but reversibility is poorly understood. We examined the development and decay of bacterial resistance in community patients after antibiotic use.
methodsThis was a systematic review and meta-analysis. PubMed, EMBASE and CENTRAL (from inception to May 2017) were searched, with forward and backward citation searches of the identified studies. We contacted authors whose data were unclear, and of abstract-only reports, for further information. We considered controlled or times-series studies of patients in the community who were given antibiotics and where the subsequent prevalence of resistant bacteria was measured. Two authors extracted risk of bias and data. The meta-analysis used a fixed-effects model.
resultsOf 24,492 articles screened, five controlled and 20 time-series studies (total 16,353 children and 1461 adults) were eligible. Resistance in Streptococcus pneumoniae initially increased fourfold after penicillin-class antibiotic exposure [odds ratio (OR) 4.2, 95% confidence interval (CI) 3.5-5.4], but this fell after 1 month (OR 1.7, 95% CI 1.3-2.1). After cephalosporin-class antibiotics, resistance increased (OR 2.2, 95%CI 1.7-2.9); and fell to (OR 1.6, 95% CI 1.2-2.3) at 1 month. After macrolide-class antibiotics, resistance increased (OR 3.8, 95% CI 1.9-7.6) and persisted for 1 month (OR 5.2, 95% CI 2.6-10.3) and 3 months (OR 8.1, 95% CI 4.6-14.2, from controlled studies and OR 2.3, 95% CI 0.6-9.4, from time-series studies). Resistance in Haemophilus influenzae after penicillins was not significantly increased (OR 1.3, 95% CI 0.9-1.9) initially but was at 1 month (OR 3.4, 95% CI 1.5-7.6), falling after 3 months (OR 1.0, 95% CI 0.5-2.2). Data were sparse for cephalosporins and macrolides. Resistance in Enterobacter increased post-exposure (OR 3.2, 95% CI 0.9-10.8, from controlled studies and OR 7.1, 95% CI 4.2-12, from time-series studies], but was lower after 1 month (OR 1.8, 95% CI 0.9-3.6).
conclusionsResistance generally increased soon after antibiotic use. For some antibiotic classes and bacteria, it partially diminished after 1 and 3 months, but longer-term data are lacking and urgently needed.
trial registrationPROSPERO CRD42015025499 .
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