Common Infections and Antibiotic Resistance covers the epidemiology, diagnosis, decision making, treatment and prevention of infection and antibiotic resistance as well as the behaviour change required to modify clinical practice.
Work in this area includes:
- the description of the natural history of acute viral upper respiratory infection in children;
- research into the resistance levels derived from surveillance using routinely submitted data;
- research in partnership with the European Respiratory Infections Network ‘GRIN’, particularly for qualitative research methods in this area.
The group conducts high quality internationally recognised research in applied infection and has produced several ‘world firsts’ including:
- Wellcome Trust funded study of risk factors for resistant urinary tract infections identified recent antibiotic use and low dose, longer courses as risks. This was also the first study to demonstrate the morbidity, workload and costs associated with an antibiotic resistant common infection primary care. A modelling study using unique all Wales resistance and antibiotic prescribing data was the first to show that antibiotic resistance declined in association with reduced antibiotic prescribing at the level of general practices.
- For the first time, demonstrating an association between reduced antibiotic prescribing and reduced antibiotic resistance at the level of general practice.
- Demonstrating that antibiotic resistant UTIs are common in general practice, increase workload and NHS costs, and cause patients to be unwell for longer; quantifying risk factors for resistant UTIs, with the clinical message that fewer antibiotics, and higher dose, shorter course prescriptions = lower risk of resistant UTIs.
Professor Chris Butler and colleagues have been nominated
for the 2013 BMJ Improving Health Awards’ prestigious Research Paper of the
Year. The paper, ‘
Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial’ profiles the STAR educational
programme, finding that its use in GP practices led to reductions in all cause
oral antibiotic dispensing over the subsequent year with no significant change
in admissions to hospital, reconsultations, or costs.
The paper is one of six shortlisted in this category, which recognises 'outstanding original research that has the potential to contribute significantly to improving health and health care'. In 2007, the study was awarded the prestigious prize for Early-Stage Collaboration at the Cardiff University Innovation Network Awards.
- Describing the natural history of acute viral upper respiratory infection in children; basis for communication skills / educational training for GPs.
- RCT demonstrating that intra-nasal sodium cromoglycate does not influence course of childhood URTI.
- Identifying complex pressures on antibiotic prescribing guideline adherence: GPs balancing maintenance of relationships with patients and social responsibility.
- Demonstrating competence in GPs’ communication skills after innovative, context rich training in LRTI specific communication skills that involve peer-review of colleagues’ consultation transcripts with simulated patients.
- Identifying that lay understanding of antimicrobial resistance focuses on dirty hospitals, not perceived as a community problem over which they have some influence.
- Developing award-winning software educational program for training large numbers of practitioners: STAR study.
- The FP6, EU funded 13 country GRACE study published in the BMJ (Jun 09) showed that variation in LRTI management in Europe is not justified by variation in illness severity at presentation and that outcomes are not affected by antibiotic treatment.
- The IMPAC3T RCT published in the BMJ (May 09) showed communication skills training and C-Reactive Protein point of care testing in LRTI safely reduced antibiotic prescribing without reducing satisfaction with care.
- The EQUIP study published in the BMJ (Aug 09) demonstrates the effectiveness of in-consultation strategies to safely reduce antibiotic prescribing for children.
OSTRICH: Oral Steroids for Resolution of otitis media with effusion (OME) In Children
A new trial is underway to determine if a short course of oral steroids can improve the hearing of children suffering from glue ear, thanks to a £1.3M research grant awarded to scientists at Cardiff University. Glue ear is the most common reason for childhood surgery, with approximately 25,000 operations carried out each year in the UK. Also known as otitis media with effusion (OME), the condition is caused by an accumulation of sticky fluid in the middle ear and affects around 80% of children by the age of four.