Infection and antibiotics

Primary care is the first point of contact for, and manages the vast majority of, patients with infectious disease. Primary care is also responsible for over 80% of all health service antibiotic use. Antimicrobial resistance is at the top of the international public health agenda and is responsible for over 30,000 premature deaths in Europe annually.

The CAPC infection group conducts internationally recognised research to improve the management of acute infections and the use of antibiotics in primary care. We use mixed methods and collaborate with a wide range of disciplinary experts to conduct research in five areas:

  1. To develop and evaluate the clinical and cost effectiveness of interventions promoting self-care of infections at home
  2. To improve the targeting and effective use of antibiotics
  3. To investigate the relationship between primary care prescribed antibiotics and antimicrobial resistance
  4. To develop and evaluate the clinical and cost effectiveness of interventions to reduce the severity of infection associated symptoms
  5. To understand the social and cultural influences on the management of infections by clinicians, patients and carers, including health care utilisation, prescribing practices, and clinician-patient/carer communication.

For an overview of the research, please watch our YouTube video. More details on the projects are below.


We are a 15 strong group, who include a GP Professor, two Research Fellows, a Trial Manager, three Research Associates/Assistants, a Research Nurse, a PhD student, an Executive Assistant and five Research Administrators. Together, our success is built on the talent and commitment of our staff; our focus on impactful applied health research with high quality publications; our inter-disciplinary links within the School of Social and Community Medicine and across the University of Bristol; and our collaborative links with like-minded researchers at the Universities of Oxford, Southampton and Cardiff. With these three centres, we have an active multicentre research portfolio of nine studies valued at £14M, three of which are led by Bristol and valued at £4.4M, with a further £1.4M of Bristol-only led research.

Current projects

  • UK-China AMR Hub: Strategies to reduce the burden of antibiotic resistance in China. Lambert H, Hickman M, Yardley L, Cabral C, Yao L, Tarrant C, Oliver I, MacGowan A, Little P, Stuart B, Shi L, Fu C, Wang D et al. Funder: Medical Research Council (MRC) led Newton Fund (2019-2022)
  • RAPID: Novel upper respiratory tract microbiological point-of-care testing in children presenting to primary care with acute cough: A preliminary feasibility study. Thornton, H. Cabral, C. Hay, A. Funder: NIHR School of Primary Care Research (2018-2019)
  • Helping parents of children with respiratory tract infections decide when to consult primary care: a RAND appropriateness study. Funder: NIHR School for Primary Care Research (2018-2019).
  • ARTIC PC: Antibiotics for lower respiratory tract infection in children presenting to primary care. Rowley K, Wilson V, Hay A. Funder: NIHR Health Techonology Assessment programme (2017-2019)
  • Pathways to optimising antibiotic use in Anhui: identifying key determinants in community and clinical settings. Lambert H (PI), Wang D (PI-China), Hickman M, Hay A, Kadetz P, Cabral C, MacGowan A, Oliver I, Coope C, Kessel A, Li J, Hong Q, Jiang Q, Pan F, Hu L, Hu X, Michie S. Funder: Newton Fund (2016-2019)

Completed projects

  • Reducing the burden of paediatric respiratory tract infections to the NHS (NIHR Research Professorship). Hay A. Funder: NIHR Training and Coordinating Centre (2013-2018)
  • Pre-INACT: Preparing for improving the use of NHS primary care services and antibiotics for children with respiratory tract infections. Cabral C, Morris R, Redmond N, Thompson M, Yardley L, Little P, Hay A. Funder: NIHR Programme Development Grant (2016-2018)
  • Differences in antibiotic prescription rates between CAM GP practices and conventional GP practices in the NHS. van de Werf E. Funder: supported in part by an unrestricted grant of WALA Heilmittel GmbH, Germany 
  • The TARGET Programme: Improving the quality of care for children with respiratory tract infections in primary care. A Hay, M Thompson, P Little, B Delaney, T Peters, A Lovering, P Lucas, J Horwood, J Ingram, C Cabral, N Redmond, P Blair, P Muir, M Fletcher, S Hollinghurst, J Hayhurst, P Brindle, N Francis and C Butler. NIHR Programme Grant for Applied Research 2010-2016. The team is hosting an implementation event to showcase this exciting research in central London, 26 Feb. Further details available here.

  • CEDAR - can anaesthetic ear drops be used to manage ear pain in children? A Hay, P Blair, W Hollingworth, J Horwood, N Francis, P Little, I Williamson, M Fletcher, M Lyttle, P Stoddart, D Nunez (2015 - 2017)
  • UNPAC - Understanding the causes of miscommunication in primary care consultations for children with acute cough. C Cabral
  • EEPRIS - Evaluation of Enhanced Paediatric Respiratory Infection Surveillance, E Anderson, S Ingle, P Muir, C Beck, A Finn, J Leeming, C Cabral, J Kesten, A Hay 

  • The Oral Steroids for Acute Cough (OSAC) Trial. A Hay, P Little, M Moore M, D Kendick, E Orton, M Thompson, A Harnden, K Wang K, S Hollinghurst, H Downing H and J Sterne. NIHR School for Primary Care Research.
  • Diagnosis of Urinary Tract infection in Young children (DUTY). A Hay, C Butler, P Little, K Hood, A Macgowan, J Sterne, W Hollingworth, R Howe, P Whiting, K O'Brien, J Dudley, J van de Voort, A Montgomery, J Benger, M Fletcher, P Brindle, B Delaney. Further detail can be found on the project website:

  • PCAAR-H: Is there a relationship between primary care prescribed antibiotics and antimicrobial resistance among patients assessed for acute infection in secondary care? A HayC Costelloe, M Williams, T PetersS Hollinghurst, C Dayan and D Mant.

  • PiCArD: Parent's Choices About Daycare. F CarrollA Hay, H A-Janabi, A Owen-SmithS Hollinghurst. NIHR School for Primary Care Research

  • Treatment Options without Antibiotics for Sore Throat (TOAST). M Thompson, A Hay, M Moore, K Harman. NIHR School for Primary Care Research.

  • Alternative Treatments of Adult Female Urinary Tract Infection (ATAFUTI). M Moore, A Hay, M Willcox. NIHR School for Primary Care Research.

  • The early use of antibiotics for at risk children with influenza in primary care (ARCHIE). A Harnden, A Hay. NIHR

  • Conker: Examining the interactions and behaviours in consultations for childhood respiratory tract infections. C CabralJ Horwood, A Hay, J Ingram, P Lucas, N Redmond, J Kai. Royal College of General Practitioners, Scientific Foundation Board
  • A qualitative study and discrete choice experiment to inform an intervention to reduce the burden of infectious illness in primary care and the community. Carroll F, Hay A, Hollinghurst S, Owen-Smith A, Al-Janabi H. Funder: NIHR School for Primary Care Research (2012-2014)
  • Examining the interactions and behaviours in consultations for childhood respiratory infections. Cabral C., Horwood J, Lucas P, Ingram J, Kai J, Redmond N and Hay A. Funder: RCGP Scientific Foundation Board (2013)


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