Trends in bacterial pathogens, antibiotic resistance, antibiotic usage and patient outcomes in critical care in the Oxford University NHS Trust hospitals, 1999-2014

Antibiotics are medicines that are hugely important in treating many infections, and antibiotic resistance is a major clinical problem. Research has shown that increased use of antibiotics, whether appropriate or inappropriate, seems to be associated with higher numbers of antibiotic-resistant infections. To develop the best treatment strategies, it is important to understand which bacteria (bugs) are causing most infections and which antibiotics they are resistant to. This may vary in different hospital settings. Patients in critical care (intensive/high dependency care units) are particularly vulnerable to infections. There are however limited data on infections, antibiotic resistance and antibiotic usage in UK critical care units, and it is unclear: (i) what bugs are causing most infections in these patients; (ii) which antibiotics would be the best ones to use; and (iii) whether there is any change over time. This study would use the IORD database to answer these questions for critical care units in the OUH NHS Trust hospitals. We will look for links between antibiotic use, types of infection and common bugs, and whether this is different from other hospital wards. This information can be used to determine which antibiotic(s) is/are the best one(s) to use in critical care.