ARK-hospital
Research type
Research Study
Full title
Antibiotic Reduction and Conservation in Hospitals (ARK-Hospital)
IRAS ID
217773
Contact name
Timothy Peto
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Antibiotics kill bacteria, but don’t cure viral infections. When sick patients arrive at hospital, doctors have to work out whether they have a bacterial infection, viral infection, or another illness. This is difficult, because initial symptoms can be very similar (e.g. cough, temperature).
Finding out exactly why a patient is sick takes a while, so it makes sense to give antibiotics initially. However, Department of Health guidance recommends stopping antibiotics when it becomes clear that they aren’t needed anymore. This could be because doctors work out that the patient never had a bacterial infection, or because they have got better. Stopping antibiotics when they aren’t needed reduces the chances of disease-causing and other gut bacteria becoming resistant to antibiotics. It is also important because antibiotics kill ‘friendly’ gut bacteria. But stopping antibiotics when they are no longer needed often doesn’t happen. Sometimes this is ‘just in case’ or thinking ‘better safe than sorry’, or because of the myth that antibiotic courses must be completed to avoid resistance.
This research will test whether a package of strategies can help doctors, nurses, pharmacists and patients stop antibiotics in hospital when they are no longer needed. The package includes internet-based training, standard systems to review patients, regular support from pharmacists/infection specialists, and materials for patients. First, we will test the package in one hospital to make sure that it is practical (‘feasibility study’). We will then implement the package in 1-3 more hospitals, testing how many people use it and improving the package (‘internal pilot’). If we meet specific criteria, we will implement the package in 36 hospitals in total (‘main trial’). We will compare mortality and antibiotic use in patients admitted to general medicine before and after its introduction using data from electronic hospital records from admission to 90 days later.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
17/SC/0034
Date of REC Opinion
7 Feb 2017
REC opinion
Favourable Opinion