The relationship between prior antibiotic exposure and antibiotic "response failure" in children presenting with acute respiratory tract infections (RTI) in primary care: an observational cohort study

Date of Approval
Application Number
16_162
Technical Summary

Background
Antibiotic use for self-limiting infections can have harmful consequences. These include the development of antibiotic resistance and disruption to the human microbiome, both of which may predispose individuals to further infections which do not respond to antibiotics. Preschool children under 5 years old with respiratory tract infections (RTIs) have the highest rate of antibiotic prescribing for RTIs in primary care, although most RTIs in this age group are self-limiting (viral) illness.

Aim
To explore whether higher levels of antibiotic exposure in children is associated with a greater likelihood of subsequent acute respiratory tract infections (RTIs) failing to respond to antibiotic treatment ("response failures")

Research objective
To examine the relationship between prior antibiotic exposure and antibiotic "response failure" in children presenting with acute RTIs in primary care

Anticipated outcomes
The findings of this study will help improve our understanding of the relationship between previous antibiotic exposure for acute, mostly self-limiting RTIs and the development of further acute RTIs which fail to respond to antibiotics. Relating the consequences of unnecessary antibiotic use to more tangible and immediately relevant outcomes rather than to theoretical future harms will help inform the development of more effective educational materials and awareness campaigns to promote appropriate antibiotic prescribing and use.

Health Outcomes to be Measured

The findings of this study will help improve our understanding of the relationship between previous antibiotic exposure for acute, mostly self-limiting RTIs in preschool children, and the development of further acute RTIs which fail to respond to antibiotics.

Collaborators

Clare Bankhead - Chief Investigator - University of Oxford
Oliver Van Hecke - Corresponding Applicant - University of Oxford
Alice Fuller - Collaborator - University of Oxford
Christopher Butler - Collaborator - Cardiff University
Kay Wang - Collaborator - University of Oxford
Michael Moore - Collaborator - University of Southampton
Nicholas Francis - Collaborator - Cardiff University
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences

Linkages

Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation