The use of antimicrobial drugs is linked to antimicrobial resistance which can lead to infections that are harder to treat and may be associated with worse outcomes for the patient.

The use of antibiotics changed in hospital during the different waves of the COVID-19 pandemic, as data was used to assess if antibiotic therapy was associated with better health outcomes for patients with confirmed COVID-19. Looking at changes in health outcomes linked to antibiotic therapy across the whole hospital instead of only patients with COVID-19 over time will help understand if changes to antibiotic use during the pandemic may have had an impact on the risk of antibiotic resistance.

PIONEER geography The West Midlands (WM) has a population of 5.9 million and includes a diverse ethnic and socio-economic mix.

EHR: UHB is one of the largest NHS Trusts in England, providing direct acute services and specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds and an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary and secondary care record (Your Care Connected) and a patient portal “My Health”.

Scope: Longitudinal and individually linked, so that the preceding and subsequent health journey can be mapped and healthcare utilisation prior to and after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 and SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, wards and admissions), surgery procedures, microbiology reports, COVID results, prescriptions, drug administered and all outcomes.

Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation and refinement; A.I.; Data partner support for ETL (extract, transform and load) process, Clinical expertise, Patient and end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.