Firstly, why this project?

From the beginning we were really enthusiastic about our project as we believed a device could have a large impact on the health of many. Our device, was focused on a general biomarker of bacterial infection to widen its application and make a bigger impact.

What was our understanding of the problem at the start of our project?

At the start of the project our initial research focused on human antibiotic misprescription (the prescription of antibiotics where they will be of no benefit to the individual taking them). The Center For Disease Control and Prevention, for example, reported that 1 in 3 prescriptions of antibiotics in US for outpatients was unnecessary. The review on antimicrobial resistance chaired by Lord O’Neil reported, in 2016, that 700,000 deaths were caused by drug-resistant strains of common bacterial infections, HIV, TB and malaria every year. This is a staggering number human lives with significant economic costs. We felt that tackling misprescription in order to reduce antibiotic wastage and therefore reduce development of antibiotic-resistant bacteria was key to relieving the problem of antibiotic-resistance in bacteria and the knock-on effects that this has.

We attended a patient panel at a local hospital specifically The Research Advisory Panel for Infectious Diseases (RAPID) which had a focus on infectious disease to get a more personal perspective of antibiotic usage. One member of the panel said that generally patients want a pill, especially if they feel ill and think that they need something to help them feel better. Another panel member said that her husband never finished a course of antibiotics - he would take them until he felt better and then would stop. If he then got ill again he would start taking the rest of the antibiotics, this was because he had a no waste attitude towards the antibiotics.

From our discussions we perceived that understanding of the general public towards antibiotic use was lacking and that this was a driving force for misprescription as doctors felt under pressure to prescribe antibiotics in order to satisfy the patients.

What is our device trying to address?

When we started our project we envisaged that our device would benefit GPs in determining which patients required antibiotics. We hoped that our device would impact on the antibiotic resistance problem by giving doctors, for the first time since the use of antibiotics began, a point of care device that gives an objective likelihood of a patient having a bacterial infection. This would give them greater confidence when prescribing antibiotics and also denying antibiotics to those who do not require them. Such that, it would be an important tool for decreasing antibiotic use, ultimately to slow the spread of antibiotic resistance.

We created a flow diagram as an initial assessment of the decision making process that a GP goes through when presented with an individual potentially suffering a bacterial infection so that we could begin to work out where our decide would an impact.

As presented above, the decision process involves uncertainty, which is what we would like to reduce.

We then predicted where our device would influence the decision making of doctors.

As shown above, what we would like to achieve is that we could make the prescription process simpler by providing clinicians data on the necessity of antibiotics.