University of Dundee

The Impact of Scottish National Stewardship on E. coli Resistance and Admissions with Infection

A key approach to tackling antimicrobial resistance (AMR) is through improving the way we use antibiotics. The Scottish Antimicrobial Prescribing Group has guided improvements in antibiotic prescribing since 2008, with resulting changes in the community and in hospital. The impact of these changes on AMR and other potential adverse effects requires further evaluation. The aim is to investigate the impact of changes in antibiotic prescribing across Scotland on resistance among E. coli bacteraemia and on admissions to hospital with infections, using statistical evaluation of national prescribing data patterns over time. Joinpoint regression models will be used to establish the timing of significant changes in prescribing. The hypothesis is that these empirically identified timepoints will be associated with changes in AMR (an intended benefit) and in healthcare use related to more severe infection (a potential harm of reduced prescribing). Analysis of the impact on outcomes will use segmented regression analyses. The outcomes include admissions to hospital with E.coli bloodstream infections +/- AMR, and other unscheduled care use with infections. For individuals with these outcomes, prior antibiotic prescriptions in primary care will be examined using interrupted time series.

This project will appeal to students with cross-disciplinary interests in infectious diseases, clinical microbiology, epidemiology, statistics 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 Ben Parcell, Infection, Prevention and Control, NHS Tayside, Dundee

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 - http://www.bris.ac.uk/cellmolmed/study/postgraduate/amr/faqs/

To apply, please send a cover letter, curriculum vitae and two references to: Medicine-PGR@dundee.ac.uk

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: https://www.dundee.ac.uk/study/pg/phds/

Eligibility