Community antibiotics and the development of resistance
Research type
Research Study
Full title
Is the use of broad-spectrum antibiotics in the community associated with changes in faecal microbiota and the acquisition of bacterial strains possessing antimicrobial resistance genes? A pilot study.
IRAS ID
195920
Contact name
Ed Moran
Contact email
Sponsor organisation
Heart of England NHS FT
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Antibiotic use has been associated with the development and spread of resistant bacteria in hospitals and the community. This is thought to be a consequence of disruption to the native bacterial flora of the human intestine. New techniques in genetic sequencing now enable the study of all the genetic material present in a faecal specimen, revealing the complexity and breadth of bacterial species present. Antibiotic treatment can disrupt this dramatically with even limited antibiotic exposures resulting in high levels of resistant bacteria carriage. Up to now strategies to control antibiotic use and the spread of such organisms have been centred on healthcare institutions but with care increasingly provided in the community, outpatient parenteral antibiotic therapy (OPAT) services have developed across the UK. These services favour the use of agents that can be given once a day and coincidentally these are often the very broad-cover antibiotics that are under scrutiny in hospitals. Research has centred on the impact of broad-spectrum antibiotics in hospitals and very little is known about the consequences of their use in the community.
This pilot study will recruit patients undergoing OPAT. Faecal specimens will be analysed by DNA sequencing technology to reveal the impact of the use of antibiotic agents in the community upon the breadth and number of bacterial species present as well as the development of antibiotic resistance. We hope this may lead to further studies with the aim of optimising community-based antimicrobial stewardship strategies to minimise antibiotic-resistant healthcare-associated infection.
REC name
London - Central Research Ethics Committee
REC reference
16/LO/0927
Date of REC Opinion
11 Aug 2016
REC opinion
Further Information Favourable Opinion