Study title

Antibiotic exposure and subsequent antibiotic “response failure” in children presenting with acute respiratory tract infections (RTI) in primary care: a matched case-control study.

Principal / Lead Investigator

Oliver van Hecke, University of Oxford  

  • Chris Butler (Oxford University),
  • Kay Wang (Oxford University),
  • Michael Moore (University of Southampton),
  • Nick Francis (PRIME, Cardiff University), 
  • Clare Bankhead (Oxford University),
  • Alice Fuller (Oxford University)
Type of study

Linked data case-control study

Study sponsor

University of Oxford


Antibiotics are used to treat infections caused by bacteria. When uncertain, people sometimes seek antibiotics for infections which would have got better on their own with time. As a result, too many antibiotics are being prescribed for these types of infections. This wastes money and may have important health implications for people and their families. Preschool children are at particular risk for unnecessary antibiotics because such infections are common in childhood.

Purpose of the study
The aim of the study is to explore whether young children (under 5 years old) who are prescribed more antibiotics for a respiratory tract infection (e.g. chest, throat, ear infection), are more likely to get subsequent infections that do not respond to antibiotics.

Please describe how the public / patients were involved in the development of the study design, and how they will be involved in the funded study?

This project forms part of a larger programme of individual research wherein patient involvement has already informed and refined the topic of unnecessary antibiotic prescribing and its potential consequences. Patient representatives from local GP surgeries and the NIHR's Patients Active In Research (PAIR) group were instrumental in helping us develop our research questions. Patients (including parents of children) understood that antibiotics should not be used unnecessarily. However, they also felt that, to help them decide whether to use antibiotics in a given situation, they needed clearer information about how using antibiotics might compromise the likelihood of them being effective at treating future infections affecting themselves or their family members.

To address these questions, other ongoing research will assess whether antibiotic-resistant infections are associated with a greater likelihood of clinical response failure among patients in the community and will complement the findings of this cohort study exploring whether greater antibiotic exposure in young children with acute RTI may be associated with an increased likelihood of “response failure”.

How could this research potentially benefit patients?

This research will help find new information about the consequences of using antibiotics in young children, particularly whether children who use more antibiotics for infections that do not need them, might develop more infections that fail to respond to antibiotics. Using this new information our plan is to develop better educational material and more effective awareness campaigns to persuade people to use antibiotics responsibly


RCGP Scientific Board    

Total grant value


Start date

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End date

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Outputs generated (Reports / Publications / Impact)

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