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Beating the bugs

The challenge

Resistance to commonly-prescribed antibiotics is becoming one of the biggest global challenges we face. Globally, 480 000 people develop multi-drug resistant TB each year, and drug resistance is starting to complicate the fight against HIV and malaria. Experts fear that some previously-manageable infections are becoming untreatable with antibiotics. This is why there is an urgent need for research into public health measures, health care interventions and health services to reduce the development and spread of antimicrobial resistance and consequent morbidity.

Our research

To help tackle the problem, the NIHR has committed over £91 million into research addressing the use of antimicrobial drugs such as antibiotics. One study recently published in the Journal of Antimicrobial Chemotherapy looked at the social and professional influences on doctors-in-training prescribing antimicrobial drugs.

£1.5million trial - the largest of its kind, is looking into antibiotic treatment for sepsis. Researchers in Salford, Manchester and Warwick will determine whether one of two different tests will allow a safe reduction in the time patients in hospital with suspected sepsis are kept on antibiotics.

Professor Paul Dark, NIHR National Specialty Lead for Critical Care and Professor in Critical Care Medicine at the University of Manchester, said: “Sepsis is a very dangerous condition and we have to react very quickly if it’s suspected – it is important to start treating patients as quickly as possible.

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But there isn’t good quality evidence on which we can base a decision to stop giving antibiotics and that means that even when patients are getting better – and some may not have had sepsis at all – we are still giving antibiotics for at least 7-10 days.

- Professor Paul Dark

“Ultimately, we want to be able to use antibiotics more effectively, making sure we have the safest possible care for patients. The antibiotics we use for sepsis are the ones we should be preserving, to protect the health of patients both now and in the future.”

A further trial is aiming to tackle the overuse of antibiotics in hospitalised children and reduce the spread of antimicrobial resistance. The BATCH trial (‘Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection’) will use a personalised approach to safely reduce antibiotic duration in children hospitalised with bacterial infection, through the use of a specific blood test called Procalcitonin.

Our work on biomarkers of infection in children with bacterial infection has generated evidence suggesting that a personalised approach using serial measurements of biomarkers, could help to tackle antibiotic overuse in hospitalised children.

-Professor Enitan Carrol

Funding

Reducing antimicrobial resistance is a research priority for the NIHR and we are keen to receive research proposals in this area. Apply now for funding.

  1. Figures taken from World Health Organization AMR factsheet http://www.who.int/mediacentre/factsheets/fs194/en/