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How antibiotics work, and other stories

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1678 (Published 19 March 2013) Cite this as: BMJ 2013;346:f1678

Antibiotics are traditionally thought to kill bacteria by attacking various targets such as cell wall assembly and protein synthesis. This theory was recently superseded by a proposed “universal mechanism,” whereby antibiotics stimulate the formation of reactive oxygen species that destroy bacterial DNA. Two studies in Science now show that several antibiotics work whether reactive oxygen species are present or not, rebutting this latest hypothesis (2013;339:1210-6, doi:10.1126/science.1232751; doi:10.1126/science.1232688).

A systematic review of 25 trials with 1754 patients reports that intravenous magnesium sulphate added to β2 agonists and systemic steroids to treat acute asthma significantly improves lung function in children and reduces hospital admissions (Respiratory Medicine 2013;107:321-30, doi:10.1016/j.rmed.2012.12.001). But intravenous magnesium did not prevent hospital admissions in adults, and nebulised magnesium offered benefits to adults only.

Does the use of three dimensional imaging to capture the …

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