***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: All newborn infants in East Anglia are screened for cystic fibrosis by blood immunoreactive trypsin assay at 7 days . Thirty eight infants with cystic fibrosis were r and omised to treatment with either continuous oral flucloxacillin 250 mg/day ( group P , n = 18 ) or with episodic antimicrobials as clinical ly indicated ( group E , n = 20 ) . Their progress was monitored from diagnosis to 24 months by a nurse coordinator who visited all infants regularly , at home and in hospital , to collect anthropometric , dietary , clinical , and microbiological data . Mean ( range ) age of confirmation of diagnosis was 5.7 weeks ( 1 - 14 weeks ) . There was no significant difference in birth weight , genotype , immunoreactive trypsin concentration , neonatal history , symptoms at diagnosis , pancreatic enzyme supplementation , or parental smoking history between the groups . Infants in group E had more frequent cough and a greater number of Staphylococcus aureus isolates than infants in group P. More infants of group E were admitted to hospital , had higher admission rates during the second year ( 19 v 5 ) , for longer periods ( 6.4 v 2.2 days ) , despite receiving more than double the number of courses of antibiotics than group P infants ( in addition to flucloxacillin ) . Continuous prophylactic flucloxacillin from early diagnosis of cystic fibrosis is associated with improved clinical progress during the first two years of life The nature and timing of lower respiratory infections in infants with cystic fibrosis is largely unknown1 because infants do not produce sputum and throat cultures may not predict lower respiratory pathogens.2 We performed a prospect i ve cross sectional study of an unselected cohort of infants with cystic fibrosis in which bronchoalveolar lavage was used to determine lower respiratory infection and inflammation during the first three months of life . The state of Victoria , Australia ( 66000 births per year ) has a cystic fibrosis screening programme , all patients being managed by one centre . Between February 1992 and September 1994 we recruited 45 ( 27 boys ) of the 52 infants with newly diagnosed disease ; 32 were identified by screening , 12 from meconium ileus , and one by failure to thrive , and all cases were confirmed by sweat testing . Sixteen infants had respiratory symptoms , and seven of them were receiving oral antibiotics when bronchoalveolar lavage was performed at a mean age of 2.6 ( SD 1.6 ) months . Nine otherwise healthy infants ( five boys ) aged The effect of prophylactic antibiotics on bacterial colonization of the respiratory tract and on general progression of  cystic fibrosis  was studied in a two-year prospect i ve study of 47 mildly to moderately affected patients . One group of patients received inhaled cephaloridine and the other received no inhaled antibiotic ; both groups received cloxacillin orally .  Carriage of Haemophilus influenzae was greater in the group not receiving inhaled antibiotic ( 55 % vs 20 % ) . Rates of carriage of Staphylococcus aureus ( 23 % ) . Pseudomonas aeruginosa ( greater than 90 % ) . Pseudomonas cepacia ( 45 % ) , and other organisms were similar in both groups . There were no significant differences between the two groups in incidence of respiratory tract infections or hospital admissions , clinical scores , radiologic scores , or rate of change of pulmonary function . Although continuous antistaphylococcal antibiotic prophylaxis may be successful in suppressing colonization with S. aureus , it may also contribute to the high rates of carriage of Ps . aeruginosa and Ps . cepacia observed in patients with cystic fibrosis Since 1982 all infants born within the East Anglian Regional Health Authority have been screened for cystic fibrosis . Between April 1985 and April 1992 infants identified in this way have been entered into a r and omised prospect i ve controlled trial of antibiotic prophylaxis . Approximately half the infants received continuous oral flucloxacillin and the remainder received antibiotics when clinical ly indicated . Infants underwent tests of respiratory function at 3 - 4 months and at 1 year of age . Measurements of thoracic gas volume and airway conductance were made with an infant whole body plethysmograph , and maximum expiratory flow by the ' squeeze ' technique . A total of 73 tests was performed of 42 infants . To facilitate comparisons , measurements were expressed as scores . The mean values of the scores for the two groups of infants fell within normal limits . There was no difference between the treatment groups at either age . A reduction in airways conductance was observed between the two tests The effects of oral administration of cephalexin were evaluated in a double-blind , placebo-controlled , crossover study in 17 patients with mild to moderate pulmonary disease due to cystic fibrosis . For two years , four-month periods with cephalexin were alternated with four-month placebo periods . Thus , patients served as their own control subjects . Fungal vulvovaginitis occurred in two patients and a cephalexin-resistant Enterobacter cloacae was acquired in the sputum of another patient during cephalexin therapy . During the 2 years of study , the rate of colonization with mucoid strains of Pseudomonas aeruginosa increased and disease severity deteriorated in patients initially colonized with P. aeruginosa . Short-term courses of sputum culture-specific antibiotics improved the course of some patients with mild to moderate pulmonary disease due to cystic fibrosis . Treatment with cephalexin decreased the frequency of respiratory illnesses , respiratory illnesses requiring antibiotics , and hospitalizations for respiratory illnesses in patients initially colonized with Staphylococcus aureus and /or Haemophilus influenzae , and also reduced colonization with these organisms . Improved weight gain in 16 of 17 patients was associated with periods of cephalexin therapy . Pulmonary function tests remained stable or improved in 10 of 14 patients . Disease severity improved in patients not colonized with P. aeruginosa OBJECTIVES To evaluate whether antistaphylococcal prophylaxis in infants and young children with cystic fibrosis ( CF ) would suppress the acquisition of Staphylococcus aureus and delay the onset of the manifestations of bronchopulmonary disease . STUDY DESIGN A 7-year , multicenter , double-blind , placebo-controlled study of continuous antistaphylococcal therapy .  Otherwise healthy children < 2 years of age with CF were r and omly assigned to be treated with daily cephalexin ( 80 - 100 mg/kg/day ) or placebo .  Clinical , microbiologic , laboratory , radiographic , and anthropometric outcomes were evaluated . RESULTS Of 209 children enrolled , 119 completed a 5- to 7-year course of therapy . Mean age at enrollment was 15.6 and 14.1 months in the cephalexin and placebo groups , respectively . Respiratory cultures from children treated with cephalexin were significantly less likely to be positive for S aureus ( 6.0 % vs 30.4 % ; P < .001 ) . They were , however , much more likely to be positive for Pseudomonas aeruginosa ( 25.6 % vs 13.5 % ; P < .009 ) . These differences became apparent in the first year after enrollment and persisted over the duration of the study . In contrast to these microbiologic differences , there were no differences in clinical outcome measures , including radiographic ( Brasfield score , 23.4 vs 23.2 ) or anthropometric scores or pulmonary function . CONCLUSIONS Although long-term prophylaxis with cephalexin successfully delayed the acquisition of S aureus , it enhanced colonization with P aeruginosa and did not lead to clinical ly significant improvement in major health outcomes . These data do not support routine antistaphylococcal prophylaxisin otherwise healthy infants and young children with CF [ N PATIENTS with cystic fibrosis , the progression of pulmonary disease following Staphylococcus aureus colonization and the improvement after its eradication suggest that S. aureus may be more important than Pseudomonas aeruginosa and Haemophilus influenzae as primary pathogens . 1'~ The favorable results in CF patients using continuous antistaphylococcal therapy with cloxacillin 3 support this idea . Moreover , S. aureus produces microabscesses of the lung 4 and remains in a CF patient 's sputum despite prolonged administration of antibiotics ? Patients with cystic fibrosis developed precipitating antibodies against S. aureus more frequently than against other sputum pathogens . We therefore studied 29 CF patients receiving prophylactic pulmonary care 6 at the University of Minnesota Hospitals who gave informed consent for treatment of staphylococcal infections with clindamycin Screening of the newborn for cystic fibrosis by measurement of immunoreactive trypsin has been undertaken on alternate weeks in Wales and the West Midl and s for five years since 1985 to evaluate the possible clinical benefits of early diagnosis . Patients detected by screening and those diagnosed by clinical symptoms alone were assessed annually for differences in clinical , anthropometric , and biochemical variables .  Fifty eight infants not considered to be at risk of cystic fibrosis ( they did not present with meconium ileus and do not have a sibling with cystic fibrosis ) have been detected by screening and they have been compared with 44 children who were diagnosed clinical ly . This latter group includes nine children whose screening was negative but who were recognised subsequently to have cystic fibrosis . The mean age at diagnosis of the screened group was significantly lower than that of the group diagnosed clinical ly . Excluding admissions for diagnostic tests for cystic fibrosis , the screened group spent a significantly shorter time in hospital during the first year of life . The results of all other comparisons made between the screened group and those diagnosed clinical ly were similar up to the age of 4 years To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrollment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results 
    Output:
    
A reduced prevalence of Staphylococcus aureus in the respiratory secretions was seen in children receiving  anti-staphylococcal antibiotic prophylaxis  , although no effect was seen on other common pathogens .
There was a trend towards a lower cumulative isolation rate of Pseudomonas aeruginosa in the prophylaxis group , after three years .
However , as the duration of the studies review ed has been of three years or less , conclusions can not be drawn about the long term effects of prophylaxis on acquisition of P. aeruginosa and survival .
REVIEW ER 'S CONCLUSIONS Anti-staphylococcal antibiotic prophylaxis may be of benefit when commenced early in infancy and continued up to three years of age .
There is insufficient evidence from this review to say whether use in older children , or adults , or for periods of over three years is beneficial