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:

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.

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Aim/research questions

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.

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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:

  1. in-depth examination of the surgical pathway context (healthcare organisation, home, and national level policies and constraints) using strategic analysis and ethnography
  2. co-design and implementation of interventions
  3. 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

Funding partners