Dr. Charis A Marwick

Clinical Senior Lecturer/Honorary Consultant

Clostridium difficile infection, antimicrobial use and resistance: epidemiology and improvement research


Population Health Sciences,
School of Medicine,
Mackenzie Building,
Kirsty Semple Way

Phone Number:

+(44) 01382 383800

Email Address:



Dr Charis Marwick is a Clinical Senior Lecturer in Population Health Sciences, Consultant in Infectious Diseases and General Medicine in NHS Tayside and Clinical Lead for the Scottish infection Intelligence Platform at NHS National Services Scotland (NSS).

She completed her PhD, through a CSO Clinical Academic Fellowship, at the University of Dundee in 2011 and completed clinical training in June 2012. Her undergraduate degrees, MBChB July 2001 and BScMedSci 1st Class honours July 1999, were from the University of Glasgow.

Her research into the epidemiology of infections, particularly Clostridium difficile infection (CDI), antimicrobial use and antimicrobial resistance (AMR) generates and evaluates evidence to support changes in policy and practice, and evaluates the impact of changes in policy, often involving the use of health informatics. Her multidisciplinary research, including national collaborations through the Scottish Infection Research Network and the Scottish Healthcare Associated Infection Prevention Institute, includes linking bacterial genomic data to routine healthcare data to investigate CDI and AMR. She is a member of the Scottish Antimicrobial Prescribing Group representing IIP and research and chairs the 2016 Scottish CDI Guidance Development Group.


Current research grants:

  • Marwick CA, Chalmers JD, Donnan PT, Nathwani D. The impact of antimicrobial exposure on subsequent antimicrobial resistance in patients with COPD and bronchiectasis. Chief Scientist Office. £225K

  • Marwick C, Douce G, Coia J, Brown D, Quince C, Donnan P, Lindstrom J, Bennie M, Wiuff C, Davey P. Molecular epidemiology of Clostridium difficile in Scotland: developing novel, clinically applicable research methods to combine genomic analysis with health informatics. Scottish Infection Research Network/Chief Scientist Office. £366,638

  • Leonard A, Aanensen D, Bennie M, Coia J, Currie K, Evans T, Gillespie S, Holden M, Knussen C, Lang S, Marwick C, McCowan C, Morris K, Parcell B, Parkhill J, Phillips G, Price L, Reilly J, Robertson C, Walsh T. Scottish Healthcare Associated Infection Prevention Institute (SHAIPI). SIRN Consortium  £4,249,749

  • Leanord A, McCowan C, Walker A, Ford I, Robertson C, Kavanagh K, Bennie M, Marwick C. Clinical and economic outcomes of C. difficile infection in Scotland. Astellas Pharma Ltd £180,237

  • Guthrie B, Marwick C, Davey P, Clarkson J. Health Foundation PhD Awards for Improvement Science. £278,782

  • Davey P, Marwick C, Charani E, Gould I, Ramsay C. Systematic review and meta-analysis of interventions to improve antibiotic prescribing practices for hospital inpatients. Chief Scientist Office. £174,906

  • Hernandez Santiago V, Marwick CA, Davey PG, Guthrie B. A multilevel analysis of the impact of changes in antimicrobial prescribing on antimicrobial resistance. Chief Scientist Office, Clinical Academic Training Fellowship for Dr Hernandez Santiago. £215,658


Walker H, Patton A, Bayne G, Marwick C, Sneddon J, Davey P, Nathwani D, Bell S. Reduction in post-operative acute kidney injury following a change in antibiotic prophylaxis policy for orthopaedic surgery: an observational study. Journal of Antimicrobial Chemotherapy 2016; 71(9): 2598-605

Stewardson AJ, Allignol A, Beyersmann J, Graves N, Schumacher M, Meyer R, Tacconelli E , De Angelis G, Farina C, Pezzoli F, Bertrand X, Gbaguidi-Haore H, Edgeworth J, Tosas O, Martinez JA, Ayala-Blanco MP, Pan A, Zoncada A, Marwick CA, Nathwani D, Seifert H, Hos N, Hagel S, Pletz M, Harbarth S. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study. Eurosurveillance 2016; 21(33)

Francis NA, Ridd MJ, Thomas-Jones E, Shepherd V, Butler CC, Hood K, Huang C, Addison K, Longo M, Marwick C, Wootton M, Howe R, Roberts A, Haq MI-U, Madhok V, Sullivan FA. Randomised placebo-controlled trial of oral and topical antibiotics for children with clinically infected eczema in the community: the ChildRen with Eczema, Antibiotic Management (CREAM) study. Health Technology Assessment 2016; 20(19): 1-84.

Rae N, Jarchow-Macdonald A, Nathwani D, Marwick CA. MRSA: treating people with infection. BMJ Clinical Evidence 2016

Francis NA, Ridd MJ, Thomas-Jones E, Shepherd V, Butler CC, Hood K, Huang C, Addison K, Longo M, Marwick C, Wootton M, Howe R, Roberts A, Inaam-ul Haq M, Madhok V, Sullivan F on behalf of the CREAM team. A randomised placebo controlled trial of oral and topical antibiotics for children with clinically infected eczema in the community: the ChildRen with Eczema, Antibiotic Management (CREAM) Study. Health Technol Assess 2016;20(19)

Bell S, Dekker FW, Vadiveloo T, Marwick C, Deshmukh H, Donnan PT, Van Diepen M. Risk of post-operative AKI in patients undergoing orthopaedic surgery – development and validation of a risk score and effect of AKI on survival: an observational cohort study. British Medical Journal 2015;351:h56392015

Burton LA, Price RJG, Barr KE, McAuley SM, Allen JB, Clinton AM, Phillips G, Marwick CA, McMurdo MET, Witham MD. Hospital Acquired Pneumonia incidence, risk markers and diagnosis in older patients. Age Ageing 2016; 45(1): 171-174

Hernandez-Santiago V, Marwick C, Patton A, Davey P, Donnan P, Guthrie B. Time series analysis of the impact of an intervention in Tayside, Scotland to reduce primary care broad-spectrum antimicrobial use. Journal of Antimicrobial Chemotherapy 2015; 70(8): 2397-404

Kennedy H, Wilson S, Marwick C, Malcolm W, Nathwani D. Reduction in broad-spectrum Gram-negative agents by diverse prescribing of aztreonam within NHS Tayside (research letter). Journal of Antimicrobial Chemotherapy 2015; 70(8): 2421-3

Davey P, Peden C, Charani E, Marwick C, Michie S. Time for action—Improving the design and reporting of behaviour change interventions for antimicrobial stewardship in hospitals: Early findings from a systematic review. International Journal of Antimicrobial Agents 2015; 45(3): 203-12

McAuley SM. Price RJG, Phillips G, Marwick CA, McMurdo MET, Witham MD. Interventions to prevent non-critical care hospital acquired pneumonia – a systematic review. European Geriatric Medicine 2015; 6(4): 336-40

Davey P, Peden C, Brown E, Charani E, Michie S, Ramsay C, Marwick C. Interventions to improve antibiotic prescribing practices for hospital inpatients (updated protocol). Cochrane Database of Systematic Reviews 2014; 23(12)

Stewardson AJ, Harbarth S, Graves N on behalf of the TIMBER Study Group. Valuation of hospital bed-days released by infection control programs: a comparison of methods. Infection Control and Hospital Epidemiology 2014; 35(10): 1294-7

Bell S, Davey P, Nathwani D, Marwick C, Vadiveloo T, Sneddon J, Patton A, Bennie M, Fleming S, Donnan PT. Risk of AKI with Gentamicin as Surgical Prophylaxis. Journal of the American Society of Nephrology 2014; 25(11): 2625-32

Marwick CA, Guthrie B, Pringle JEC, McLeod SR, Evans JMM, Davey PG. Identifying which septic patients have increased mortality risk using severity scores: a cohort study. BMC Anesthesiology 2014; 14(1)

Marwick CA, Nathwani D. Linking process measures to outcome for patients with complicated urinary tract infection: it's complicated. Editorial commentary. Clinical Infectious Diseases 2014; 58(2): 170-2

Marwick CA, Guthrie B, Pringle JEC, Evans JMM, Nathwani D, Donnan PT, Davey PG. A multifaceted intervention to improve sepsis management in general hospital wards with evaluation using segmented regression of interrupted time series. BMJ Quality & Safety 2013; 23(12)

Marwick CA, Yu N, Lockhart MC, McGuigan CC, Wiuff C, Davey PG, Donnan PT. Community-associated Clostridium difficile infection among older people in Tayside, Scotland is associated with antibiotic exposure and care home residence: cohort study with nested case-control. Journal Antimicrobial Chemotherapy 2013; 68(12): 2927-33

Marwick C, Hernandez Santiago V, McCowan C, Broomhall B, Davey P. Community acquired infections in older patients admitted to hospital from care homes versus the community: cohort study of microbiology and outcomes. BMC Geriatrics 2013; 13(12)

Johnston T, Yeoman T, Chapman S, Marwick C, Nathwani D. Audit of Staphylococcus aureus bacteraemia management in NHS Tayside and comparison with European Antibiotic Strategies study group international quality standards. J Antimicrob Chemother 2012; 67(9): 2304-6

Marwick C, Rae N, Irvine N, Davey PG. Prospective study of severity assessment and management of acute medical admissions with skin and soft tissue infection. J Antimicrob Chemother 2012; 67(4): 1016-9

Marwick C, Broomhall J, McCowan C, Phillips G, Gonzalez-McQuire S, Akhras K, Merchant S, Nathwani D, Davey PG. Severity assessment of skin and soft tissue infections: cohort study of management and outcomes for hospitalised patients. J Antimicrob Chemother 2011; 66: 387-97

Nathwani D, Davey PG, Marwick CA. MRSA: treating people with infection. BMJ Clinical Evidence 2010; 10: 922

Defres S, Marwick C, Nathwani D. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia. Eur Respir J 2010; 34: 1-7

Marwick C and Davey PG. Care bundles: the holy grail of infectious risk management in hospital? Curr. Op. Infectious Diseases 2009; 22(4): 364-9

Easton PM, Marwick CA, Williams FLR, Stringer K, McCowan C, Davey PG, Nathwani D. A survey on public knowledge and perceptions of methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 2009; 63: 209-14

Davey PG, Marwick C. Appropriate vs. inappropriate antimicrobial therapy. Clin Microbiol Infect 2008; 14(Suppl.3): 15-21

Marwick CA, Watts E, Evans J, Davey PG. Quality of care in sepsis management: development and testing of measures for improvement. J Antimicrob Chemother 2007; 60: 694-7

Easton P, Sarma A, Williams F, Marwick CA, Phillips G, Nathwani D. MRSA; Infection Control & Management: Assessing the knowledge of staff in an acute hospital setting. J Hosp Infect 2007; 66(1): 29-33

Marwick CA, Nathwani D. Improving antimicrobial prescribing through knowledge and skills (Letter/Comment). J Antimicrob Chemother 2007; 59(4): 819-20

Marwick CA, Ziglam HH, Nathwani D. Your patient has a blood culture positive for Staphylococcus aureus – what do you do? J R Coll Physicians Edinb 2006; 36: 350-5

Marwick C, Olver WJ. Treatment of Staphylococcus aureus bacteraemia (Letter/Comment). BMJ 2006; 333(7564): 397

Marwick CA, Nathwani D. Fever in the Returning Traveller. Behind the Medical Headlines, the RCPE, RCSEd, and RCPSG [article on the Internet]. July 2006.


<p>Undergraduate clinical teaching in Infectious Diseases during 4th year ID block</p>
<p><span style="font-size: 13.008px; line-height: 1.538em;">Supervision of student projects in infection</span></p>
<p><span style="font-size: 13.008px; line-height: 1.538em;">Medical school examinations</span></p>
<p><span style="font-size: 13.008px; line-height: 1.538em;">Clinical academic mentoring</span></p>
<p><span style="font-size: 13.008px; line-height: 1.538em;">Thesis Monitoring Committee for PhD students</span></p>
<p><span style="font-size: 13.008px; line-height: 1.538em;">Supervising, marking and moderating Masters dissertations</span></p>

PhD Supervision

<p><span style="font-size: 13.008px; line-height: 1.538em;">Andrea Patton, Evaluating effects of antimicrobial stewardship interventions, 2017</span></p><p><span style="font-size: 13.008px; line-height: 1.538em;">Virginia Hernandez Santiago, A multilevel analysis of the impact of changes in antimicrobial prescribing on antimicrobial resistance, 2017</span></p><p><span style="font-size: 13.008px; line-height: 1.538em;">Sean MacBride-Steward, Measuring and improving primary care prescribing quality and safety using routine data, 2017</span></p><p>&nbsp;</p>


Multidisciplinary and health informatics approaches to tackling AMR.

Learned Society Partnership on Antimicrobial Resistance Networking workshop for researchers; Antimicrobial resistance: environments, evolution and transmission, College of Life Sciences, University of Dundee, 3rd July 2015

Infection Intelligence Platform (IIP): using big data to define infection outcomes.

RCPE Symposium: Emerging and re-emerging infectious diseases, Royal College of Physicians of Edinburgh, 12th June 2015

Evidence for the use of new and old agents for Staphylococcus aureus infections.

Federation of Infection Societies (FIS) annual scientific meeting, Birmingham, 13th November 2013




<p><span style="font-size: 13.008px; line-height: 1.538em;">The paper Bell S, Davey P, Nathwani D, </span><strong style="font-size: 13.008px; line-height: 1.538em;">Marwick C</strong><span style="font-size: 13.008px; line-height: 1.538em;">, Vadiveloo T, Sneddon J, Patton A, Bennie M, Fleming S, Donnan PT. Risk of AKI with Gentamicin as Surgical Prophylaxis. Journal of the American Society of Nephrology 2014:25, led to a change in the national orthopaedic antibiotic prophylaxis policy</span></p>