Petsavers: Antibiotic prescription in canine and feline gastroenteritis
Antimicrobial resistance (AMR) is widely recognised as an increasingly important global health threat. Evidence of transmission of bacterial resistance amongst human beings, livestock 1 and companion animals 2 demonstrates the necessity of a ‘one health’ approach to preserve treatment efficacy. Although use of antibiotics selects for and promotes transfer of resistance, data on antibiotic prescription (AP) to date are limited in animals.
The Small Animal Veterinary Surveillance Network (SAVSNET) collects large volumes of anonymised health records from a sentinel network of UK veterinary practitioners in real-time (savsnet.co.uk). Recently, we have used these data to identify the most common antibiotics prescribed, showing that 38% of dogs and 30% of cats presenting with gastroenteritis are prescribed systemic antibiotics 9.
In this Petsavers 60th Anniversary Master’s by Research, we will build on this work, combining for the first time quantitative and more qualitative approaches with SAVSNET “Big Data” data, to better understand antibiotic choices of practitioners, focussing on the syndrome gastroenteritis, and the clinical signs vomiting and diarrhoea.
• the unique SAVSNET classifier that means each health record collected is also coded in real-time by the attending practitioner based on the main reason for presentation (currently gastroenteritis as well as respiratory disease, tumour, trauma, vaccination, post-op check, other),
• text mining to automatically identify animals with vomiting and/or diarrhoea in the clinical narrative as well as to automatically extract dosage data and animal weight data where these are recorded, and
• qualitative approaches to describe the extent to which antibiotic choices are justified in the health record
The successful candidate will receive training in quantitative and qualitative epidemiology, as well as text mining of big data. Specific training will be provided in
• Epidemiology; univariable and multivariable approaches to risk analyses as implemented in R.
• Text mining; using regular expressions to extract actionable meaning from the clinical narrative as implemented in programmes such as Python and R.
• Social science approaches and content analysis using Nvivo
• Taught postgraduate module providing an Introduction to Qualitative Research, such as that that is part of Masters in Public Health, University of Liverpool.
• Working with “Big Data” including ethical considerations and data protection, practice recruitment, data capture and data cleaning.
• There will also be support in preparing results for presentation and publication to specialist and other audiences.
These complementary approaches will give new insight into the antibiotic choices made by practitioners when faced with one of the most common clinical presentations in practice. As well as traditional research publications, the results of this Master’s degree will feed directly back to practitioners through existing benchmarking sites already available to those practices supplying data, as well as through the BSAVA portal and to others through the recently launched mySavsnet AMR. This will ensure the results of this Master’s degree are rapidly translated into best veterinary practice.
The project will be based at the University of Liverpool’s Leahurst campus. The Institute of Infection & Global Health is fully committed to promoting gender equality in all activities. In recruitment we emphasise the supportive nature of the working environment and the flexible family support that the University provides. The Institute holds a silver Athena SWAN award in recognition of ongoing commitment to ensuring that the Athena SWAN principles are embedded in its activities and strategic initiatives.
It is a requirement of the funding that the successful candidate start in post by 1st October 2018.
To apply please send a CV and the names and contact details of two referees to pgrapps@liverpool.ac.uk.
Funding Notes
This project is funded by BSAVA Petsavers as a 60th Anniversary Award. A student stipend of upto £18,000 is available for this project, which will also cover all necessary postgraduate fees.
References
[1] Cuny et al (2015) Antibiotics 4, 521-43. [2] Zhang et al (2016) EID 22,1679-81. [3] Mateus (2011) JSAP 52 (2011), 515-21, [4] Radford et al (2011) Vet Rec 169, 310. [5] Buckland et al (2016) Vet Rec 179, 489. [6] Trott et al (2004) J Med Micro 53, 439-443. [7] Johnson et al (2008) J Clin Micro 46, 417-22. [8] Beco et al (2013) Vet Rec 172, 72-8. [10] Singleton et al (2017) The Vet J 224, 8-24. [11] Jones et al (2014) The Vet J 201, 412-8.