Infection and antibiotics

Primary care is the first point of contact for, and manages the vast majority of, patients with infectious disease. Primary care is also responsible for over 80% of all health service antibiotic use. Antimicrobial resistance is at the top of the international public health agenda and is responsible for over 30,000 premature deaths in Europe annually.

Bacteria floating in a blue background

Primary care is the first point of contact for, and manages the vast majority of, patients with infectious disease. Primary care is also responsible for over 80% of all health service antibiotic use. Antimicrobial resistance is at the top of the international public health agenda and is responsible for over 30,000 premature deaths in Europe annually.

The CAPC infection group conducts internationally recognised research to improve the management of acute infections and the use of antibiotics in primary care. We use mixed methods and collaborate with a wide range of disciplinary experts to conduct research in five areas:

  1. To evaluate the clinical and cost effectiveness of interventions to prevent infection acquisition
  2. To investigate the clinical and cost effectiveness of interventions to reduce the severity of infection associated symptoms
  3. To improve the targeting, and thereby effective use, of antibiotics
  4. To investigate the relationship between primary care prescribed antibiotics and antimicrobial resistance
  5. To understand the social and cultural influences on the management of infections by clinicians, patients and carers, including health care utilisation, prescribing practices, and clinician-patient/carer communication.

More details on the projects are given below.

We are a 15 strong group, who include a GP Professor, one Lecturer, one Research Fellow, a Trial Manager, two Trial Coordinators, two Senior Research Associates, one Research Associate, a Research Nurse, an Executive Assistant and two Research Administrators. Together, our success is built on the talent and commitment of our staff; our focus on impactful applied health research with high quality publications; our inter-disciplinary links within the Bristol Medical School and across the University of Bristol; and our collaborative links with like-minded researchers at the Universities of Oxford, Southampton, London, Manchester and Cardiff.

Current projects

  • Developing evidence based optimal testing strategies to monitor long term conditions in primary care. Whiting, P, Hay, AD, Jones, H, Sterne, J, Watson, J, Thom, H, Hollingworth, W, Banks, J, Thomas, C, Stokes, C, Palmer, F. Funder: NIHR (2021 to 2025)
  • Determining clinicAl perforMance of novEL dIagnostics fOr uRinAry Tract infection (AMELIORATE). Hayward G, Butler C, Fanshawe T, Turner P, Moore M, Hay AD, Allen J, Glogowska M. Funder: NIHR School for Primary Care Research (2022 to 2024)
  • Microbiology IPD. Stuart B, Hayward G, Hay AD. Funder: NIHR School for Primary Care Research (2022-2024)
  • DISCO UTI. Francis N, Moore A, Hay AD. Funder: NIHR School for Primary Care Research (2022-2023)
  • Precision antimicrobial prescribing: safeguarding patient outcomes and preserving future efficacy (part of South West Better Care Partnership). Dowsey A, Turner K, Hay AD, Hammond A, Williams P, Lazarus R, Vergnano S, Albur M, MacGowan A, Heys I, Hamilton F, Sterne J, Hickman M, Lawson D, Homer M, Brooks Pollock E, Danon L, Avison M, Feil E, Sheppard S, Hopkins S, Oliver I, Kwiatkowska R. Funder: Health Data Research UK (2020 to 2023).
  • Effectiveness of analgesic ear drops as add-on treatment to oral analgesics in children with acute otitis media: a pragmatic randomised controlled trial. Venekamp RP, Damoiseaux RAMJ, de Wit NJ, de Wit GA, Hay AD, Little P, Sanders EAM, Schilder AGM, Yardley L, Funders: Zuithoff NPA and ZonMw KPHAG (2021 to 2025)
  • First line antimicrobials for urinary tract infection in primary care - investigating the emergence of nitrofurantoin resistancef in urinary tract infections caused by Escherichia coli. Hammond A, Hay A, Avison M, Hopkins S, Dowsey A, Turner K. Funder: BMA Foundation's Kathleen Harper 2020 Grant Award (September 2020-September 2022)
  • Reducing Common infections in Usual practice for Recurrent Respiratory tract infections. (RECUR) Little P, Geraghty A, Hay AD, Butler C, Moore M, Verheij T, Richards-Hall S, Rathod S, Lily Yao G, Stuart B, Yardley L, Seely J, Raftery J, Ainsworth B, Bradbury K. Funder: National Institute for Health Research (NIHR) (2019-2024)
  • Vaccination in older adults: understanding how to do it better and knowing when to stop. Christensen H. Funder: National Institute for Health Research (NIHR) (2019-2024)

Sexually transmissible infections

Completed projects

  • Woodall C, Hammond A, Hay AD. Daphne Jackson Fellowship (2020 to 2021) 
  • What is the optimum strategy for identifying adults and children with coeliac disease?  A systematic review and economic models. Whiting P, Gillet P, Robins G, Everitt H, Jones H, Thom H, Elwenspoek M, Sheppard A, Hay AD, Watson J, Lane D, Stubbs J. Funder: NIHR (2020 to 2021) 
  • Exploring diagnostic strategies for streptococcal throat infection in community pharmacies: a feasibility study. Francis N, Lown M, Moore M, Little P, Hayward G, Hay AD, Stuart B, Bostock J, Glogowska M, Mantzourani E, and Butler C. Funder: NIHR School for Primary Care Research (2020 to 2021) 
  • LOngitudinal study of behaviours, risk factors, and effects of COVID-19 in the Community (LOCC): a large, rapid online observational study. Nick, F, Little, P, Hay, AD, Moore, M, Lown, M, Stuart, B, Bostock, J, Keppy, J, Geraghty, A, Yardley, L, Willcox, M, Hu, X-J (Mio), Becque, T and Newman S. Funder: NIHR School for Primary Care Research (2020 to 2021)  
  • Primary Care Evaluation of Covid-19 Infection Surveillance in our Network (PRECISION) Study. Duncan P, Grant S, Clayton J, Mukit A, Turner K, Hay AD. Funder: UKRI (2020 to 2021)
  • Saline Nasal Irrigation For acute Sinusitis II (SNIFSII). Little P, Hall S, Hay AD, Hamden A, Zhu S, Butler C, Moore M, Verheij T, Ainsworth B, Thomas M, Francis N, Hopkins C, Venekamp R, Yardley L, Stuart B Funder: NIHR School for Primary Care Research (2018-2020)
  • Non-antimicrobial treatment for women with uncomplicated urinary tract infection presenting to primary care – an individual patient data analysis. Gagyor I, Jüni P, Friede T, Debray T, Hay AD, Little P, Moore, M Ferry S, Christiaens T, Vik I, Lindbaek M.  Funder: DLR Projkttrager (2018 to 2020)
  • Rapid diagnosis of Urinary Tract Infection in Primary Healthcare. Drake M, Micciche A, Lovering A, Hayward G, Jeays-Ward K, Jacobson SK, Hay AD, Kiely J, Luxton R, Langley J, McCarthy A, Skews R, Yang Y. Funder: NIHR (2018-2021)
  • Christensen H, Lasseter G, Huxtable R, Cabral C and Hay AD. Evaluation of patient access to medical test result services in General Practice. Funder: Department of Health, Policy Research programme (2018 to 2020)
  • D-Mannose to prevent Recurrent UTI: a double-blind randomised placebo controlled trial. Hayward G, Butler C, Hay AD, Moore M, Flower A, Yang Y, Nickless A, Cook J, Allen J, Glogowska M. Funder: NIHR School for Primary Care Research (2017 to 2020)
  • RAPID: Novel upper respiratory tract microbiological point-of-care testing in children presenting to primary care with acute cough: A preliminary feasibility study. Khalid TDuncan L.Thornton H, Lasseter G., Hay, A. Funder: NIHR School of Primary Care Research (2018-2019)
  • Helping parents of children with respiratory tract infections decide when to consult primary care: a RAND appropriateness study. Funder: NIHR School for Primary Care Research (2018-2019).
  • ARTIC PC: Antibiotics for lower respiratory tract infection in children presenting to primary care. Rowley KWilson VHay A. Funder: NIHR Health Techonology Assessment programme (2017-2019)
  • Pathways to optimising antibiotic use in Anhui: identifying key determinants in community and clinical settings. Lambert H (PI), Wang D (PI-China), Hickman MHay A, Kadetz P, Cabral C, MacGowan A, Oliver I, Coope C, Kessel A, Li J, Hong Q, Jiang Q, Pan F, Hu L, Hu X, Michie S. Funder: Newton Fund (2016-2019)
  • Developing clinically useful subgroups from urine samples reported as ‘mixed growth’ to guide primary care clinicians.Hayward G, Butler C, Moore M, Hay AD, Fanshawe T.  Funder: NIHR School for Primary Care Research (2017 to 2018)
  • Feasibility Study of Pelargonium Sidoides Root Extract EPS®7630 (Kaloba®) for Lower Respiratory Tract Infection In Adults. Moore M, Lewith G, Little P, Hay AD, Willcox M, Butler C, Flower A, Eyles C, Yao L, Griffiths G, Bostock J, Bell M. Funder: NIHR School for Primary Care Research (2017 to 2018)
  • Pre-INACT: Preparing for improving the use of NHS primary care services and antibiotics for children with respiratory tract infections. Cabral C, Morris R, Redmond N, Thompson M, Yardley L, Little P, Hay A. Funder: NIHR Programme Development Grant (2016-2018)
  • Acquisition and Selection of Antibiotic Resistance in Companion and Farmed Animals and Implications for Transmission to Humans. Avison A, MacGowan A, Hay AD, Barrett D, Reyher K, Cogan T, Casey R, Tasker S, Turner K, May M. Funder: Natural Environment Research Council (2016 to 2019)
  • Morbidity following urinary tract infection in young children: an electronic record-linked cohort study. O'Brien K, Cannings-John R, Paranjothy S, Francis N, Hay AD, Hood K, Butler C. Funder: NISCHR Health Research Awards, Health and Care Research Wales (2015 to 2018)
  • Reducing the burden of paediatric respiratory tract infections to the NHS (NIHR Research Professorship). Hay A. Funder: NIHR Training and Coordinating Centre (2013-2018)
  • Differences in antibiotic prescription rates between CAM GP practices and conventional GP practices in the NHS. van de Werf E. Funder: supported in part by an unrestricted grant of WALA Heilmittel GmbH, Germany 
  • The TARGET Programme: Improving the quality of care for children with respiratory tract infections in primary care. A Hay, M Thompson, P Little, B Delaney, T Peters, A Lovering, P Lucas, J Horwood, J Ingram, C Cabral, N Redmond, P Blair, P Muir, M Fletcher, S Hollinghurst, J Hayhurst, P Brindle, N Francis and C Butler. NIHR Programme Grant for Applied Research 2010-2016. The team is hosting an implementation event to showcase this exciting research in central London, 26 Feb. Further details available here.

  • CEDAR - can anaesthetic ear drops be used to manage ear pain in children? A Hay, P Blair, W Hollingworth, J Horwood, N Francis, P Little, I Williamson, M Fletcher, M Lyttle, P Stoddart, D Nunez (2015 - 2017)
  • UNPAC - Understanding the causes of miscommunication in primary care consultations for children with acute cough. Cabral. C. Horwood, J. Symonds, J. Ingram, J. Lucas, P. Redmond, N. Kai, J. Hay, A., Barnes, R. Funder: NIHR School for Primary Care Research (2013-2017) 
  • Investigating the potential benefit of enhanced or alternative interventions for infectious disease control: a focus on adolescent vaccination and contact tracing.
    Christensen H (PI). Collaborators: Trotter CL, Turner K, Finn A. Funder: National Institute of Health Research Post-Doctoral Fellowship (2013-2015)

  • EEPRIS - Evaluation of Enhanced Paediatric Respiratory Infection Surveillance, E Anderson, S Ingle, P Muir, C Beck, A Finn, J Leeming, C Cabral, J Kesten, A Hay 

  • The Oral Steroids for Acute Cough (OSAC) Trial. A Hay, P Little, M Moore M, D Kendick, E Orton, M Thompson, A Harnden, K Wang K, S Hollinghurst, H Downing H and J Sterne. NIHR School for Primary Care Research.
  • Diagnosis of Urinary Tract infection in Young children (DUTY). A Hay, C Butler, P Little, K Hood, A Macgowan, J Sterne, W Hollingworth, R Howe, P Whiting, K O'Brien, J Dudley, J van de Voort, A Montgomery, J Benger, M Fletcher, P Brindle, B Delaney. Further detail can be found on the project website: http://www.dutystudy.org.uk
  • Modelling the impact of vaccination targeted against serogroup B meningococcal disease. Christensen H (PI). Supervisors: Trotter CL, Hickman M, Edmunds WJE. Funder: National Institute of Health Research Researcher Development Award (2007-2010)
  • PCAAR-H: Is there a relationship between primary care prescribed antibiotics and antimicrobial resistance among patients assessed for acute infection in secondary care? A HayC Costelloe, M Williams, T PetersS Hollinghurst, C Dayan and D Mant.

  • PiCArD: Parent's Choices About Daycare. F CarrollA Hay, H A-Janabi, A Owen-SmithS Hollinghurst. NIHR School for Primary Care Research

  • Treatment Options without Antibiotics for Sore Throat (TOAST). M Thompson, A Hay, M Moore, K Harman. NIHR School for Primary Care Research.

  • Alternative Treatments of Adult Female Urinary Tract Infection (ATAFUTI). M Moore, A Hay, M Willcox. NIHR School for Primary Care Research.

  • The early use of antibiotics for at risk children with influenza in primary care (ARCHIE). A Harnden, A Hay. NIHR

  • Conker: Examining the interactions and behaviours in consultations for childhood respiratory tract infections. C CabralJ Horwood, A Hay, J Ingram, P Lucas, N Redmond, J Kai. Royal College of General Practitioners, Scientific Foundation Board
  • A qualitative study and discrete choice experiment to inform an intervention to reduce the burden of infectious illness in primary care and the community. Carroll F, Hay A, Hollinghurst S, Owen-Smith A, Al-Janabi H. Funder: NIHR School for Primary Care Research (2012-2014)

 

Back to 'Management of Disease'

 

Edit this page