RT Journal Article SR Electronic T1 Symptom reporting, healthcare-seeking behaviour and antibiotic use for common infections: protocol for Bug Watch, a prospective community cohort study JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e028676 DO 10.1136/bmjopen-2018-028676 VO 9 IS 5 A1 Smith, Catherine M A1 Conolly, Anne A1 Fuller, Christopher A1 Hill, Suzanne A1 Lorencatto, Fabiana A1 Marcheselli, Franziska A1 Michie, Susan A1 Mindell, Jennifer S A1 Ridd, Matthew J A1 Shallcross, Laura J A1 Tsakos, Georgios A1 Hayward, Andrew A1 Fragaszy, Ellen B YR 2019 UL http://bmjopen.bmj.com/content/9/5/e028676.abstract AB Introduction Antimicrobial resistance is a significant worldwide problem largely driven by selective pressure exerted through antibiotic use. Preserving antibiotics requires identification of opportunities to safely reduce prescriptions, for example in the management of mild common infections in the community. However, more information is needed on how infections are usually managed and what proportion lead to consultation and antibiotic use. The aim of this study is to quantify consultation and prescribing patterns in the community for a range of common acute infection syndromes (respiratory, gastrointestinal, skin/soft tissue, mouth/dental, eye and urinary tract). This will inform development of interventions to improve antibiotic stewardship as part of a larger programme of work, Preserving Antibiotics through Safe Stewardship.Methods and analysis This will be an online prospective community cohort study in England. We will invite 19 510 adults who previously took part in a nationally representative survey (the Health Survey for England) and consented to be contacted about future studies. Adults will also be asked to register their children. Data collection will consist of a baseline registration survey followed by weekly surveys sent by email for 6 months. Weekly surveys will collect information on symptoms of common infections, healthcare-seeking behaviour and use of treatments including antibiotics. We will calculate the proportions of infection syndromes that lead to General Practitioner consultation and antibiotic prescription. We will investigate how healthcare-seeking and treatment behaviours vary by demographics, social deprivation, infection profiles and knowledge and attitudes towards antibiotics, and will apply behavioural theory to investigate barriers and enablers to these behaviours.Ethics and dissemination This study has been given ethical approval by the University College London Research Ethics Committee (ID 11813/001). Each participant will provide informed consent upon registration. We will disseminate our work through publication in peer-reviewed academic journals. Anonymised data will be made available through the UK Data Service (https://www.ukdataservice.ac.uk/).