Will reducing antibiotics cause more infections?

antibiotics
Researchers from Imperial are investigating whether reducing the number of antibiotics prescribed to patients could increase serious infections. 
In a bid to combat the growing number of bacteria resistant to our most commonly used treatments, medical staff and patients have recently been urged to reduce antibiotic use.

Not only has the NHS issued guidance and policies to lower unnecessary antibiotic prescriptions, but a recent Government report predicted the annual death toll from drug resistant infections could reach 10 million people globally by 2050 – more than currently die of cancer.

Unnecessary or inappropriate prescribing of antibiotic is a key driver of resistance, yet a recent report revealed an overall increase in antibiotic prescribing in 2014 in England.

However, despite the urgency to reduce antibiotic prescribing, no research has yet been conducted to assess whether limiting antibiotic use could lead to unintended consequences – such as a greater number of patients being admitted to hospital with serious infections.

During an 18-month project, scientists from the Imperial NIHR Health Protection Research Unit (HPRU) will investigate this topic, combining data from hospital admissions and GP appointments, as well as mortality data. They will use this information to monitor whether reducing the number of antibiotics prescribed to patients could lead to an increase in the number of serious infections, and even deaths.

This is the first time the side effects of reduced antibiotic prescribing have ever been investigated, explained Professor Alison Holmes, director of the HPRU: “No country in the world – until now – has yet investigated whether such policies inadvertently led to an increase in sickness or death. Yet it’s crucial to establish whether Government actions are compromising care, so that we can take targeted action to avoid this.”

The project is independent research commissioned and funded by the Department of Health Policy Research Programme.

The data from this project will be vital in shaping antibiotic policy and guidance in the UK added Professor Paul Aylin, from the Department of Medicine at Imperial, who will be over-seeing the project: “In this study we can track whether the complications of simple infections – such as pneumonia from a chest infection or kidney complications from a bladder infection – rise due to reduced antibiotic prescribing. We can also monitor whether reduced prescribing is leading to more people being hospitalised, or re-admitted, with infections.”

Imperial is also host to the Antimicrobial Research Collaborative (ARC@Imperial), which consolidates world leading, multidisciplinary research into antimicrobial resistance.

Professor Mike Sharland, who chairs the Government’s advisory committee on Antimicrobial Resistance and Healthcare Associated Infection, and is Professor of Paediatric Infectious Diseases at St George’s, University of London, added: “It is clearly vital that any policy initiative that is focussing on reducing inappropriate antibiotic prescribing also puts into place a detailed process to monitor for any very unlikely potential impact on clinical outcomes. This imperial-led project will be vital in ensuring any potential negative impact of national antibiotic prescribing policies can be identified, and prevented.”