A study led by Professor Martin Llewelyn, Consultant in Infection at UHSussex and Professor of Infectious Diseases at Brighton and Sussex Medical School, has been linked to a change in antibiotic prescribing behaviour and a reduction in antibiotic use.
Prof Martin Llewelyn and a team of researchers developed a new toolkit, called the antibiotic review kit (ARK), which was first introduced into Royal Sussex County and Princess Royal hospitals, to help tackle antibiotics being overly or unnecessarily prescribed in hospital settings and carried out a study to understand its effectiveness.
Antibiotics are prescribed when a person is unwell, to treat or prevent some types of bacterial infection. Delaying treatment can be dangerous, so antibiotics can be prescribed before laboratory tests have confirmed that the infection is bacterial.
However, overuse or unnecessarily using antibiotics, increases the chance of bacteria developing resistance and rendering the antibiotics ineffective.
Prof Llewelyn, who led the clinical evaluation for the study, said: “The study set out to help prescribers stop antibiotics that were unnecessary sooner, as well as more often when it was safe to do so. By doing this, patients could be protected from harms of antibiotic overuse, in particular, risk of antimicrobial resistant infections in the future.”
The kit has four elements, a prescribing decision aid which makes it easier for prescribers to stop antibiotics at a review within 72 hours, online training which takes approximately 15 minutes to complete, implementation guidance and a patient leaflet explaining why they might be prescribed antibiotics and then be taken off them.
Between February 2018 and July 2019, the toolkit was introduced into acute care wards at 39 UK hospitals, with the study ending in September 2020 and its data evaluated.
The study, which was recently published, showed that over 30,000 people were trained by the researchers on the toolkit, including doctors who do the prescribing, along with other key clinicians, such as nurses and pharmacists, who can help guide prescribing decisions.
A year after the toolkit was implemented, the study showed hospitals had reduced their overall antibiotic use by almost 5%, compared to the previous year. This reduction is substantially more than the 1% required of acute NHS trusts at the time of the study.
Hospitals with higher rates of training on the toolkit had seen greater reductions in antibiotic prescribing, supporting the researcher’s theory that the toolkit’s approach could lead to lasting behaviour change.
The researchers have now applied for funding to explore how to use the full toolkit with electronic prescribing methods and are also calling for hospitals to use the toolkit in staff training, to help embed it in their prescribing processes and stewardship work.
Research and innovation are one of the key strategic themes for University Hospitals Sussex, towards achieving the vision of excellent care every time.
As part of this, the Trust is currently setting the target of widening access to clinical trials and getting more patients and staff involved in more research studies.