ASPIRES: Antibiotic use across Surgical Pathways - Investigating, Redesigning and Evaluating Systems
Optimising antibiotic usage along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes
ASPIRES is a collaboration between:
- Imperial College London
- King’s College London
- University of Leicester
- University of Hertfordshire
- Royal College of Anaesthetists
- University of Cape Town
- Amrita Institute of Medical Sciences
- University Teaching Hospital of Butare
The funding for this 4-year project comes from the Economic and Social Research Council (ESRC) and is part of a cross-council initiative encompassing the ESRC’s Global Challenge Research Fund (GCRF) funding allocation. Further information can be found on the UKRI website.
How can antibiotic use be optimised along the entire surgical pathway - that is before, during and after surgery and in the different settings (home, primary and hospital care)?
This involves developing behavioural, structural and technological interventions which are context specific.
Key research questions
Why are we doing this?
Antibiotic resistance presents a major global threat, and overuse/misuse of antibiotics is a contributing factor. Infection prevention and correct antibiotic use in surgical patients can have a major positive impact, but this area is under-researched.
Surgery tends to be viewed as a highly technical and bounded event rather than as part of a whole pathway in which antibiotic use can be coordinated and managed. In lower and middle-income countries, where resources are highly constrained and where a lot happens in reactive rather than planned or proactive mode, making improvements along this pathway has been a challenge.
How are we doing this?
The research involves a multidisciplinary team looking at this issue in England, Scotland, South Africa, India and Rwanda, and involves:
- in-depth examination of the surgical pathway context (healthcare organisation, home, and national level policies and constraints) using strategic analysis and ethnography
- co-design and implementation of interventions
- evaluation (health outcomes and economic) using a ‘system dynamics’ approach which models the impacts of parallel interventions, and how they conflict or help towards the intended aim