Using the ESPAUR report to Spark Meaningful Conversation: Reflections from a Journal Club Presentation  

By Bee Yean Ng and Dr Louise Dunsmure 

Antimicrobial Stewardship Pharmacist team, Oxford University Hospitals NHS Foundation Trust  

As a member of the Microbiology and Infectious Diseases journal club at Oxford University Hospitals, one of the things I value most is the opportunity to reflect on how evidence shapes the decisions we make every day.  

With this in mind, when discussing potential topics for the weekly Microbiology and Infectious Diseases journal club, Dr Louise Dunsmure, Consultant Antimicrobial Stewardship Pharmacist at Oxford University Hospital NHS Foundation Trust suggested for me to present the ESPAUR report which triggered a lot of engaging multidisciplinary discussion about empirical treatment choices, resistance patterns, and how the data applied to patients in practice.  

The core journal club members include Consultant Microbiologists, Consultant Infectious Diseases, Microbiology and Infectious Diseases registrars, Pharmacists, and Infection Prevention and Control nurses. 

National vs local resistant patterns  

We began by looking at the national antimicrobial resistance (AMR) trends highlighted in the ESPAUR report. This led to an in-depth discussion about which changes were statistically significant and how national trends compared with our own local microbiology data. 

A key topic was Gram-negative bacteraemia, particularly resistance to empirical regimens like co-amoxiclav and gentamicin. Reassuringly, we found that local trends in Oxford broadly aligned with those in the ESPAUR report and resistant rates to gentamicin were still relatively low. This gave us confidence in our empirical choices and in our local practice of giving a single dose of gentamicin instead of escalating to broad spectrum antibiotic while awaiting culture results is still an appropriate approach.  

Bringing health Inequalities into stewardship discussions 

Another section of the ESPAUR report that prompted thoughtful reflection was the data included on health inequalities. This led to discussion around how factors such as deprivation may impact on an individuals risk of infection and antibiotic use, contributing to the inequities seen in AMR burden. 

How the session was received 

The session was well received across the multidisciplinary team. Reviewing the ESPAUR report in a journal club format led to a lot of healthy discussion which made the data more relevant to day-to-day practice.  

Personal reflections 

Presenting the contents of the ESPAUR report this way was genuinely useful. It wasn’t about memorising national data; it was about asking how that data actually fits into the real world — our wards, our prescribing habits, and our patient outcomes. 

If you’re considering integrating elements of the ESPAUR report into your own educational or clinical discussions, here are some tips based on what worked well: 

1. Use the ESPAUR report to spark conversation, not just present data 

Pick a few themes—AMR trends, prescribing patterns, health inequalities—and let the group explore them. 

2. Bring in local data where possible

Seeing national and local patterns side by side makes the discussion more meaningful. 

3. Link the data to real clinical questions

For example: Is our current empirical regimen still justified based on local resistance patterns? 

4. Encourage multidisciplinary participation

Different perspectives often lead to richer insights. 

5. Keep the focus on application, not just knowledge

For example: What does this mean for how we prescribe tomorrow?