Infection, Respiratory and Acute Care (IRAC)

We investigate infectious and respiratory diseases in primary care to find out how we can diagnose these better and find more effective ways of monitoring and treating patients, including identifying patients with serious illness early and avoiding hospital admission, whilst reducing antibiotic use.

Infectious Diseases Research Group

We are working on a number of studies looking at how to diagnose and treat various common infectious diseases in children and adults in primary care, and how to diagnose and monitor patients with respiratory conditions such as asthma and COPD.

Our work is important because it will help primary care clinicians to decide how best to identify which patients presenting with common symptoms such as coughs and colds are most likely to develop serious complications. This will help GPs know which patients are most likely to benefit from antibiotics. This can help to reduce unnecessary prescribing of antibiotics that is adding to resistance to antibiotics worldwide.

We investigate novel diagnostics to help better target antibiotics in primary care infection, such as C-reactive protein point-of-care testing e.g. PACE trial for COPD exacerbations, which won the RCGP Research Paper of the Year award. In parallel, we are running trials to investigate treatments other than antibiotics for patients presenting with common cough and cold symptoms. This may give GPs and patients treatment options other than antibiotics to help relieve symptoms for these common illnesses. As well as national research, we conduct international trials, many across multiple European countries (PRUDENCE/ECRAID PRIME).

Researchers from our group have been heavily involved in large platform trials of treatments and diagnostics in the COVID-19 pandemic (PANORAMIC/PRINCIPLE/RAPTOR) which are the largest ever recruiting primary care studies to date.

In respiratory disease, we are working to improve diagnosis in primary care. Asthma and COPD are conditions affecting millions of patients across the UK but current diagnostic options are limited – for example, spirometry requires specialist training to perform and is not available widely in primary care, and many patients are misdiagnosed, leading to suboptimal care. We are developing diagnostic platform studies for testing novel diagnostic technologies in assessment of suspected asthma, acute and chronic breathlessness, working alongside technology companies. We are also working on studies which investigate monitoring of asthma and COPD using diagnostic and digital technology to help empower patients to self-manage their condition.

Many of our researchers are major contributors to the NIHR Community MedTech and In Vitro Diagnostics Co-operative which is hosted by this department. Our researchers also lead the Behaviour, Implementation Science and Qualitative methods in Infections research Team (BISQIT) which utilises behavioural science and qualitative methods to identify how to deliver better primary care for patients with infections.

Infections team 2019