IPAP-UTI
Research type
Research Study
Full title
Improving primary care antibiotic prescribing to reduce antibiotic resistant urine infections: the IPAP-UTI series of cluster randomised controlled trials
IRAS ID
341598
Contact name
Alastair Hay
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Our overall aim of the IPAP-UTI programme is to provide reliable evidence to support UK policy regarding the choice of antibiotics for urinary tract infections (UTIs) in primary care, in response to local antibiotic (antimicrobial) resistance (AMR) challenges.
AMR is a serious threat to public health. Unchecked, bacteria become resistant to more antibiotics until infections become untreatable. By 2050, some predict more people will die from AMR than cancer. UTIs are the most common bacterial infection treated in the NHS, mostly using antibiotics prescribed by GPs and nurses. Recent research suggests up to 50% of bacteria which cause UTIs are resistant, resulting in longer, more severe infections, requiring multiple antibiotic courses. GPs and nurses have recently been encouraged to prescribe nitrofurantoin instead of trimethoprim (both first-line antibiotics for UTI). Some studies suggest this reduced trimethoprim AMR rates, but not everywhere, and concerningly may have led to higher AMR against other antibiotics. But there is uncertainty about the reliability of this data (because methods used mean there could be other reasons for the changes).
A randomised controlled trial (RCT) Is the only reliable method to investigate the effects of a treatment. This IRAS application is for work stream 3-4 of the IPAP-UTI programme which involves a series of cluster RCTs. The RCTs will be conducted in the areas with the worst AMR problems, and will include the groups most affected, reporting differences across socioeconomic and ethnic groups. Within the IPAP-UTI RCTs, some GP practices (randomly chosen within our target areas of high AMR) will receive an intervention encouraging them to use an alternative antibiotic, while remaining GP practices continue with usual care. At the end, we will compare antibiotic use and AMR rates, and expect that where we see differences, they will be due to the intervention.
REC name
London - Westminster Research Ethics Committee
REC reference
24/LO/0486
Date of REC Opinion
19 Aug 2024
REC opinion
Further Information Favourable Opinion