University of Dundee

Comparison of Antimicrobial Stewardship Programmes and Impact on Primary Care Prescribing in Scotland and England

Interventions to reduce antibiotic prescribing, with the aim of reducing antimicrobial resistance (AMR), have been implemented across the UK as part of antimicrobial stewardship programmes (ASPs). There are differences between NHS Scotland and NHS England in the design and implementation of ASPs, such as financial incentives in England. The aim is to describe these differences in detail, and quantify the impact of ASPs and their key components on antibiotic prescribing in primary care in each setting. This mixed methods project is aligned with large AMR research consortia in Scotland and England. It will start with descriptive comparison of national ASPs in both settings, followed by case studies in Scottish Health Boards (HBs), including qualitative interviews, to explore implementation at local level, with findings compared to those of a current study in NHS England Clinical Commissioning Groups (CCGs). Statistical analysis of primary care prescribing data over time will apply both segmented regression analyses with pre-specified intervention time points and joinpoint analyses (JPA), where the software identifies significant changes in trends, to quantify the effects of ASPs and their key components. Variation in effect at HB and CCG level will also be explored with JPA.

This project will appeal to students with cross-disciplinary interests in antimicrobial prescribing and stewardship, pharmacoepidemiology, statistics, policy research and implementation science.

The successful candidate will be enrolled in the MRC Quantitative and Interdisciplinary Biomedicine (QIBIOMED) Doctoral Training Programme at Dundee which will provide additional training opportunities and local student cohort activities.

Main supervisor: Dr Charis Marwick, Population Health Sciences, School of Medicine, University of Dundee

Co-supervisors: Prof Bruce Guthrie, Population Health Sciences, School of Medicine, University of Dundee and Dr Céire Costelloe, Department of Medicine, Imperial College London

These studentships are open to overseas students if they can top up the tuition fees to the overseas rate. The PhD programme has funds for UK tuition rates -

To apply, please send a cover letter, curriculum vitae and two references to:

Please state clearly in your cover letter that you are applying for a Medical Research Foundation National PhD Training Programme in AMR Research funded project and give the project title. Eligibility criteria for postgraduate study at the University of Dundee and the UCAS Postgraduate system (which the successful candidate will be required to complete after interview and offer of the studentship) are available here: