Dr Gavin Barlow

MBChB DTM&H MD FRCP

Senior Clinical Lecturer in Infection

Role at Hull York Medical School

Gavin Barlow is Senior Clinical Lecturer at Hull York Medical School at the University of York and an Honorary Consultant in Infection at Hull University Teaching Hospitals NHS Trust. He is also the phase III (final year) academic lead for medicine at Hull York Medical School.

Biography

Gavin qualified in medicine at Leicester University, UK in 1993 and trained in infectious diseases and general internal medicine in Leeds, Sheffield and Dundee, including a two-year research training fellowship at the University of Dundee. He commenced as Senior Clinical Lecturer at HYMS and the University of York, UK on 1st August 2019, having previously been a full-time Consultant Physician in Infection at Hull University Teaching Hospitals (HUTH) since November 2004. Between 2005 and 2018, he led a successful antimicrobial stewardship programme at HUTH that benchmarks well nationally. He was the British Society for Antimicrobial Chemotherapy (BSAC) Officer for Stewardship and Surveillance 2016-2019 and is the inaugural research editor of JAC Antimicrobial Resistance https://academic.oup.com/jacamr.

GB’s main clinical interests are orthopaedic infection, outpatient parenteral antibiotic therapy (OPAT), and the management of complex bacterial and healthcare-associated infections. GB was awarded Fellowship of the Royal College of Physicians, London in 2009. He has more than 80 publications, is a co-editor of the infection chapter in Clinical Medicine, Kumar & Clark, was a chapter editor for BSAC’s e-book Antimicrobial Stewardship: From Principles to Practice http://bsac.org.uk/antimicrobial-stewardship-from-principles-to-practice-e-book/ and co-lead of week 2 of the massive open on-line course (MOOC) in antibiotic stewardship http://antimicrobial-stewardship-mooc.com/. He was also a member of the implementation sub-group for the most recent version of Start Smart Then Focus https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/417032/Start_Smart_Then_Focus_FINAL.PDF.

Research

Research interests are broad, but predominantly focus on the epidemiology and clinical care of severe infections, common in the NHS (see publications). Ongoing research includes projects that focus on: the effects of combination antibiotic therapy, including beta-lactam combinations, on antibiotic resistant bacteria; an assessment of the impact of a dedicated Clostridium difficile infection ward on patient outcomes; a systematic review of systematic reviews about the impact of procalcitonin on antibiotic prescribing; an evaluation of Tedizolid in clinical practice; and the impact of OPAT on the gut microbiota. Working cross-site between the University of York and HUTH provides considerable opportunities for clinically focused, inter-disciplinary translational infection research.

Teaching

Phase III (Year 5) Academic Lead, Hull York Medical School

Publications

Full Publications List:

https://scholar.google.co.uk/citations?user=VTBIZUgAAAAJ

Selected publications

Oral versus Intravenous Antibiotics for Bone and Joint Infections (OVIVA), HK Li, I Rombach, R Zambellas, AS Walker, M McNally, B Atkins, D Stubbs1, A Brent, J Lomas, R Gundle, M Rogers, A Taylor, M Kumin, BA Lipsky, H Hughes, D Bose, B Angus, I Byren, A Berendt, S Warren, F Fitzgerald, D Mack, S Hopkins, J Folb, MC Hoyle, H Reynolds, E Moore, K Cox, N Jenkins, E Moran, A Woodhouse, S Stafford, RA Seaton, C Vallance, C Hemsley, K Bisnauthsing, J Sandoe, J Calderwood, I Aggarwal, S Ellis, D Bunn, R Sutherland, G Barlow, et al. N Engl J Med. 2019 Jan 31;380(5):425-436. doi: 10.1056/NEJMoa1710926.

Adjunctive rifampin for adults with Staphylococcus aureus bacteremia. Thwaites GE, Scarborough M, Szubert A, Nsutebu E, Tilley R, Greig J, Wyllie SA, Wilson P, Auckland C, Cairns J, Ward D, Lal P, Guleri A, Jenkins N, Sutton J, Wiselka W, Armando G-R, Graham C, Chadwick PR, Barlow G, et al on behalf of the United Kingdom Clinical Infection Research Group (UKCIRG). Lancet. 2017 Dec 14. pii: S0140-6736(17)32456-X.

Clinical challenges in antimicrobial resistance. Barlow G. Nature Microbiology. 2018 Mar;3(3):258-260. doi: 10.1038/s41564-018-0121-y

Reducing door to antibiotic time in community-acquired pneumonia: controlled before and after evaluation and cost-effectiveness analysis. Barlow G, Nathwani D, Williams F, Ogston S, Winter J, Jones M, Slane P, Myers E, Sullivan F, Stevens N, Duffey R, Lowden K, Davey P. Thorax 2007; 62: 67-74.

The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community-acquired pneumonia. Barlow G, Nathwani D, Davey P. Thorax 2007; 62: 253-9.

Identifying barriers to the rapid administration of appropriate antibiotics in community-acquired pneumonia. Barlow G, Nathwani D, Myers E, Sullivan F, Stevens N, Duffy R, Davey P. J Antimicrobial Chemotherapy 2008 Feb; 61: 442-51.

Development and impact of a massive open on-line course [MOOC] for antimicrobial stewardship. Sneddon J, Barlow G, Bradley S, Brink A, Chandy SJ, Nathwani D. J Antimicrobial Chemotherapy 2018 Apr 1;73(4):1091-1097. doi: 10.1093/jac/dkx493

Long Term Mortality Following Blood Stream Infection. Lillie P, Allen J, Hall C, Walsh C, Adams K, Thaker H, Moss P, Barlow G. Clinical Microbiology Infection 2012 Nov 15. doi: 10.1111/1469-0691.12101

Escherichia coli bloodstream infection outcomes and preventability: a six-month prospective observational study. Lillie PJ, Johnson G, Ivan M, Barlow GD, Moss PJ. J Hosp Infect. 2019 May 23. pii: S0195-6701(19)30220-8. doi: 10.1016/j.jhin.2019.05.007.

Economic evaluations of interventions to prevent healthcare-associated infections. Craig D, O’Connor J, Duffy S, Barlow G, et al. European Centre for Disease Prevention and Control. Stockholm: ECDC; 2017: https://ecdc.europa.eu/sites/portal/files/documents/Cost-effectiveness-of-interventions-to-prevent-and-control-HAIs-2017.pdf

Collaborations

UK Clinical Infection Research GroupInternational Staphylococcus aureus collaborationProf. James Chong, University of York (gut microbiome)Dr. Kelly Redeker, University of York (breath volatile organic compounds)Prof. Miriam Johnson, HYMS (antibiotic use towards the end of life)Prof. Hemant Sharma, HYMS (orthopaedic infection)

Postgraduate research supervision

Academic foundation

Academic clinical fellow

MSc

MD

PhD

• Supervision of the academic activities of departmental specialist trainees (since 2005); Dr. James Elston won a young investigators prize, European Congress of Clinical Microbiology & Infectious Diseases 2011 for his work on the epidemiology of pneumococcal disease in Hull and East Yorkshire and Dr. Chloe Walsh (ACF), 2011-14 (Project: Causes of Early and Late Mortality Following Invasive Pneumococcal Disease in Hull and East Yorkshire, 2007-2009) was awarded best oral presentation at HYMS postgraduate conference, 2014

• Supervision of Dr. Farah Shahi, NIHR academic clinical fellow (Project: Impact of antibiotic administration route on the diversity of the gastrointestinal tract microbiome and volatile organic compounds of the breath in patients undergoing treatment for serious bacterial infections); Dr. Shahi won the oral presentation prize at an Academy of Medical Sciences event, Leeds, Oct. 2016 and has recently been appointed to a clinical research fellow/PhD post at the U of Sheffield

• Current supervision of 3 academic foundation doctors (2018/19):

  1. Dr. Joshua York Procalcitonin to reduce antibiotic course length: A systematic review of the systematic reviews (presented at ID Week 2019, USA) and Tedizolid: A service evaluation (presented at FIS 2018, Newcastle, UK)
  2.  Dr. Joseph Suich Assessing susceptibility, and synergy in combination, of fosfomycin in Gram-negative bloodstream infection isolates (presented at ECCMID 2019, Amsterdam)
  3. Dr. Maithili Varadarajan The impact of a dedicated Clostridium difficile ward (to be submitted)

• Current supervision of 3 HYMS Phase II SSIP students (2018/19):

  1. Thomas Hubble Systematic review: Combination therapy in community-acquired pneumonia
  2.  Arin Singh Systematic review of the impact of obesity on outcomes in bacteraemia
  3.  Alicia Tickle Systematic review: Combination therapy for Staphylococcus aureus bacteraemia

• Current supervision of other junior doctors:

  1. Dr. Daniel Pan (CT2) Heterogeneity of antibiotic guidelines for common inpatient infections in the United Kingdom (presented at ECCMID 2018, Madrid; submitted for publication)
  2.  Dr. Alexander Richards (F1) Choosing Wisely in Infection: A synthesis of international infection recommendations (presented at FIS 2018, Newcastle, UK)

• Supervision of CRN funded 0.5 WTE research nurse in collaboration with critical care research nurse team

External roles

Inaugural research editor, JAC-AMR – a new open-access clinically orientated research journal focusing on antimicrobial resistance and stewardship (launch ~April 2019)

British Society for Antimicrobial Chemotherapy endocarditis guidelines committee (epidemiology section lead), 2018 onwards (updating of existing guidance)

Honours and awards

May 2001 Young Investigators Prize, 3rd European Federation of Internal Medicine (EFIM) Conference, Edinburgh Conference Centre. Unnecessary Peripheral Intravenous Catheterisation on an Acute Medical Admissions Unit. Barlow GD, Palniapan S, Jones MC, Nathwani D.

March 2009 First Prize in Patient Safety category for Antibiotic Stewardship at Hull And East Yorkshire Hospitals NHS Trust, 2005-2009, Humber and East Riding of Yorkshire NHS Service Improvement Day

April 2011 Golden Hearts award for the Outpatient Parenteral Antibiotic Therapy service in the Outstanding Customer Service category

June 2016 Nominated, Educational Supervisor of the Year, Hull and East Yorkshire Hospitals NHS Trust