Managing penicillin allergy in primary care: an important but neglected aspect of antibiotic stewardship

Supervisors: Dr Marta Wanat; Dr Sarah Tonkin-Crine

Penicillins are generally highly effective, narrow-spectrum, inexpensive antibiotics and are the first line recommended treatment for many infections. Around 6-10% of people in the UK have an allergy to penicillins listed in their medical records but, importantly, as few as 1 in 10 of them are truly allergic. This means that a significant proportion of patients are potentially restricted access to highly effective penicillins. Incorrect penicillin allergy records are associated with antimicrobial resistance (AMR), as well as health outcomes (mortality, treatment failure, surgical site infection), altered antibiotic prescribing and resource use (e.g. longer hospital stays), and this is being recognised at the policy level.

Changing penicillin allergy records is a complex process, which may require both patients and clinicians to engage in a number of behaviours. In addition to conversations with their healthcare providers, patients increasingly use digital technologies to manage their health, with additional challenges (and opportunities) being brought by them, for instance records regarding allergies being inconsistent across different platforms and the potential implications for this on subsequent prescribing.

This doctoral opportunity will enable the student to focus on the management of penicillin allergy in primary care (and beyond). The project will be shaped by student’s interests but it can involve a programme of work encompassing:

• Systematic review of current evidence related to diagnosis and management of penicillin allergy (in different settings)
• Qualitative or mixed-methods study looking at views of patients and HCPs on management of penicillin allergy
• Development of an intervention supporting patients and/or HCPs in managing penicillin allergy

The selected student will be able to develop methodological experience in systematic reviews, questionnaire/survey design, feasibility studies, qualitative data collection, and/or complex intervention design. 

Who should apply: The project will suit a student with interest in healthcare delivery research; qualitative research, and mixed methods.  Candidates will be expected to be familiar with the basics of evidence synthesis, and quantitative and qualitative research methodology as applied to healthcare settings and to hold a good undergraduate degree and a Masters degree in a relevant subject (such as clinical exercise science, public health, evidence-based health care, communications science, behavioural science).

Research group:  this DPhil will be embedded in the Infectious diseases and Acute Care Research Group with strong links with external collaborators in England (e.g. University of Leeds).