PASS research supports the development of antibiotic stewardship interventions tailored to: general practice, hospitals, care homes, and the community.

  • The Bug Watch study collected data a cohort of household residents in England
  • Participants recorded common infection symptoms and use of healthcare services
  • Bug Watch data tell us how often people go to the doctor and take antibiotics for their symptoms.

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Primary care

  • General practice is often the first point of consultation for patients with signs of infection
  • Three out of four of antibiotics in the UK are prescribed by general practitioners
  • Reducing antibiotic prescribing in this setting can significantly reduce the population-wide exposure to antibiotics, but interventions in this setting have not been reviewed systematically.

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Secondary care

  • Hospitals are responsible for 20% of the overall antibiotic use in the UK
  • They play a critical role in the acquisition and antibiotic resistance and its export to community settings
  • Despite antibiotic stewardship programmes being well established in UK hospitals, there is still evidence of antibiotic overuse.

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Care homes

  • Care homes have a strong focus on preventing and controlling infection
  • Antibiotic stewardship programmes are not common in care homes
  • Care homes represent an important setting for research to optimise antibiotic use.

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Crayton, E., Richardson, M., Fuller, C., Smith, C., Liu, S., Forbes, G., Anderson, N., Shallcross, L., Michie, S., Hayward, A., & Lorencatto, F. (2020). Interventions to improve appropriate antibiotic prescribing in long-term care facilities: A systematic review. BMC Geriatrics, 20(1), 237. DOI: 10.1186/s12877-020-01564-1

Dutey-Magni, P. F., Gill, M. J., McNulty, D., Sohal, G., Hayward, A., & Shallcross, L. (2021). Feasibility study of hospital antimicrobial stewardship analytics using electronic health records. JAC-Antimicrobial Resistance, 3(1). DOI: 10.1093/jacamr/dlab018

McCall, B., Shallcross, L., Wilson, M., Fuller, C., & Hayward, A. (2019). Storytelling as a research tool and intervention around public health perceptions and behaviour: a protocol for a systematic narrative review. BMJ Open, 9(12), e030597. DOI: 10.1136/bmjopen-2019-030597

Rockenschaub, P., Jhass, A., Freemantle, N., Aryee, A., Rafiq, M., Hayward, A., & Shallcross, L. (2019). Opportunities to reduce antibiotic prescribing for patients with COPD in primary care: a cohort study using electronic health records from the Clinical Practice Research Datalink (CPRD). Journal of Antimicrobial Chemotherapy. DOI: 10.1093/jac/dkz411

Rockenschaub, P., Hayward, A., & Shallcross, L. (2019). Antibiotic prescribing before and after the diagnosis of comorbidity: a cohort study using primary care electronic health records. Clinical Infectious Diseases. DOI: 10.1093/cid/ciz1016

Shallcross, L., Lorencatto, F., Fuller, C., Tarrant, C., West, J., Traina, R., … PASS Research Group (2020). An interdisciplinary mixed-methods approach to developing antimicrobial stewardship interventions: Protocol for the Preserving Antibiotics through Safe Stewardship (PASS) Research Programme [version 1: awaiting peer review]. Wellcome Open Research, 5(8). DOI: 10.12688/wellcomeopenres.15554.1

Shallcross, L., Rockenschaub, P., Blackburn, R., Nazareth, I., Freemantle, N., & Hayward, A. (2020). Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: A cohort study using electronic health records in England. PLOS Medicine, 17(9), e1003336. DOI: 10.1371/journal.pmed.1003336

Smith, C. M., Conolly, A., Fuller, C., Hill, S., Lorencatto, F., Marcheselli, F., … Fragaszy, E. B. (2019). Symptom reporting, healthcare-seeking behaviour and antibiotic use for common infections: protocol for Bug Watch, a prospective community cohort study. BMJ Open, 9(5), e028676. DOI: 10.1136/bmjopen-2018-028676

Smith, C. M., Williams, H., Jhass, A., Patel, S., Crayton, E., Lorencatto, F., Michie, S., Hayward, A. C., & Shallcross, L. J. (2020). Antibiotic prescribing in UK care homes 2016–2017: Retrospective cohort study of linked data. BMC Health Services Research, 20(1), 555. DOI: 10.1186/s12913-020-05422-z

Smith, C., Hayward, A., Fragaszy, E., Michie, S. (2020). Bug Watch: Baseline Data, Symptom Reporting, Healthcare-seeking Behaviours and Antibiotic Use, 2018-2019. [data collection]. UK Data Service. SN: 8734. DOI: 10.5255/UKDA-SN-8734-1

Smith, C. M., Shallcross, L. J., Dutey-Magni, P., Conolly, A., Fuller, C., Hill, S., Jhass, A., Marcheselli, F., Michie, S., Mindell, J. S., Ridd, M. J., Tsakos, G., Hayward, A. C., & Fragaszy, E. B. (2021). Incidence, healthcare-seeking behaviours, antibiotic use and natural history of common infection syndromes in England: Results from the Bug Watch community cohort study. BMC Infectious Diseases, 21(1), 105. DOI: 10.1186/s12879-021-05811-7

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