Establishing an R+D collaboration to improve antimicrobial prescribing in primary care

Resistance to antimicrobials (eg antibiotics) is a significant health problem and is driven by antimicrobial prescribing patterns. The majority of antimicrobial prescribing for humans in the UK is by GPs, but efforts to change prescribing patterns have so far met with limited success. A R+D collaboration is to be established between the key functions of the Health Protection Agency and 3 Universities with complimentary expertise relevant to improving antimicrobial prescribing in primary care. The collaboration will achieve its objectives via 4 mechanisms:
- ensuring that best practice guidance on antimicrobial prescribing is available to GPs and other primary care staff and regularly updated.
- ensuring that best practice on how to change prescribing in primary care is identified, publicised and regularly updated.
- developing and establishing a system for routinely monitoring antimicrobial prescribing in primary care to assess implementation of recommendations and to act as a tool for furure research.
- acting as a focus for further research bids in this area.
This bid is for a project manager to implement the collaboration and organise bids for funding to develop the 4 strands of work.

The emergence of bacterial strains that are increasingly resistant to antimicrobial agents is of growing national and worldwide concern. The spread of antimicrobial resistance has been driven by the widespread use of antibiotics, either appropriately or inappropriately, and is costly in both human and financial terms. Furthermore, countries with higher community antibiotic prescribing have been shown to have higher antibiotic resistance rates in several pathogens. The Standing Medical Advissory Committee report published by the Department of Health in 1998 made recommendations to limit inappropriate prescribing as a means of reducing the emergence of antimicrobial resistance and since then a range of initiatives have been undertaken. However, although some changes in behaviour have occurred, translating these recommendations into clinical practice has so far had only limited success.
This proposal is to establish a collaboration of expert sections of the Health Protection Agency with University Departments with complementary expertise and aims to improve prescribing by addressing gaps in the following 4 areas:
?< What should GPs be prescribing on the basis of current evidence to minimise antimicrobial resistance without unacceptable clinical consequences?
?< How do we achieve appropriate prescribing behaviour in primary care?
?< How do we measure what is being prescribed, whether it is appropriate and whether change is being achieved?
?< What further research needs to be done?