An investigation into the relationship between antimicrobial prescribing and antimicrobial resistance in urinary tract infections at a population level

Ironmonger, Dean (2018). An investigation into the relationship between antimicrobial prescribing and antimicrobial resistance in urinary tract infections at a population level. University of Birmingham. Ph.D.

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Abstract

The inappropriate use of antibiotics is a key factor in the development of antimicrobial resistance (AMR). UK national guidance has been ineffective in standardising the management of infections in the community. Many prescribers in the community are sceptical that their actions have an effect on AMR in their locality.
As part of this study, routine surveillance of AMR in a large regional population was established. To help interpret surveillance data, two surveys were undertaken: a survey of laboratory methods, and a survey of GP sampling and prescribing protocols. Using these survey results, surveillance tools were developed to provide hospital and community prescribers with data on antibiotic resistance in bacteria within their locality; and enable laboratories to compare methods for determining antibiotic susceptibility.
This thesis demonstrated that routine AMR surveillance can be used to monitor key antibiotic resistance, detect emergence of new or unusual resistance mechanisms, and enable the bench-marking of laboratory methods. This study was also able to demonstrate that small increases in antibiotic prescribing by individual GPs increases the number of non-susceptible bacteria isolated from specimens taken from their practice population. The results of this thesis provides supporting evidence to those developing strategies to combat AMR in the
community.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):