Accurate and real-time monitoring of antibiotic usage to reduce consumption

My Topol fellowship problem / project:

Emerging infectious diseases and antimicrobial resistance are two of the biggest threats to modern medicine.

A third of all hospitalised patients are receiving antibiotics, with a large proportion of these suffering directly of drug adverse effects or indirectly from the selection of resistance. The National Action Plan on antimicrobial resistance stipulates that electronic prescribing systems should support and drive good antimicrobial stewardship by coding, auditing, and providing healthcare providers feedback on guidance compliance and prescribing rates. This data should be used to support two key consumption goals: a 6.5% reduction in use of broad-spectrum and last- resort antibiotics, and a 2% decrease in total antibiotic use from the 2018 baseline over the next two years. As my main project, I aim to optimise an antibiotic consumption dashboard, including recoding of existing and missing antibiotics based on narrow- spectrum/broad-spectrum/last-resort category, inclusion of indication, and improved visualisations, such as tracking of performance according to annual target at Trust and departmental level. The output will be distributed to divisional and departmental governance meetings who would be empowered to devise local action plans.

As a secondary project, I aim to work with our IT team to automate extraction of patient bed movement data and microbiology results and visualise them in a timeline to facilitate the epidemiological investigation of hospital outbreaks. The ultimate aim will be to integrate this information with pathogen genomic data to improve real-time infection control investigations.

I am a Medical Microbiologist and Infectious Diseases consultant at Cambridge University Hospitals, and the Trust’s Antimicrobial Stewardship lead. As part of the latter, I have been leading on projects that harness the potential of fully electronic records to automate and improve the efficiency of the audit process.

Ι completed a PhD in bacterial genomics tracking the spread of vancomycin-resistant Enterococcus faecium across the One Health continuum. My current research focuses on the clinical and public health applications of bacterial genomics including in investigating the role of the environment in nosocomial pathogen and antimicrobial resistance transmission. I enjoy teaching, and am currently a co-lead for the Infection Module, MSt in Genomic Medicine, Institute of Continuing Education, at the University of Cambridge.