Primary Care Antibiotics and Antimicrobial Resistance in Hospital patients

In the European Union, about 25,000 patients die each year from infections caused by selected multidrugresistant bacteria and the associated costs are estimated at about 1.5 billion euros per year. The rate at which bacteria are becoming resistant is outstripping the rate at which new antibiotics are being developed. As resistance in bacteria grows it becomes more difficult to treat infections, fuelling the use of more powerful antibiotics which further contributes to the vicious cycle of resistance. As GP's prescribe over 80% of antibiotics in the UK, measures to encourage judicious antibiotic prescribing in primary care are essential. Research has shown that many GPs see the risk of resistance as theoretical and this, in combination with patients’ expectation for antibiotics can lead to inappropriate prescribing.

Evidence, from our group, shows that primary care antibiotic use is associated with carriage of resistant bacteria in relatively healthy patients. However, there has been little research to examine this association in patients who have more severe infections, requiring secondary care treatment. Knowledge of an association between primary care antibiotic use and the development of resistant infections in this group of patients could have a major influence on GP prescribing behaviour of, and patient expectation for, antibiotics. This study will investigate the association between primary care antibiotic use and resistant infections in patients who require hospital assessment for suspected infection.

This study is funded by the NIHR-School for Primary Care Research

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