Reducing antibiotic use to combat antimicrobial resistance is a priority. We want to know if we can do this safely and without putting patients at undue risk. Antibiotic use was measured over 1 week in an intensive audit of practice in the Acute/General Medicine service at the John Radcliffe. This showed that one Consultant team (Consultant A) used substantially less antibiotics compared to other teams. There was no difference in poor outcomes (death or admission to hospital) over this 1 week audit, but this is a short period of time. Every time a patient is admitted, a large amount of routine electronic data is recorded, including when they were admitted, what they were treated for, if the patient died, and which Consultant team they were treated by. We want to use this information over a longer 3 year period to see if more patients died or were admitted to hospital when they were managed under Consultant A compared to other consultant teams. If there is no difference between Consultant A and other teams, it suggests that their strategy of using substantially fewer antibiotics is safe, and can be used to reduce antibiotic use in General Medicine without risk to patients.
See manuscript on BMJ
See also blog on Modernising Medical Microbiology