Professorial Fellow in Primary Healthcare

Christopher Butler

  • I am Professor of Primary Care in the Nuffield Department of Primary Care Health Sciences.

  • I am a clinical researcher in common infections (especially the appropriate use of antibiotics, antibiotic resistance, point of care testing, and treatments for viral infections), and health care communication and behaviour change (co-author of Motivational Interviewing in Health Care).

  • I am a Fellow of the Academy of Medical Sciences and a National Institute of Health Research Senior Investigator.

  • I practise as a GP in Mountain Ash in South Wales and was the patient-nominated Royal College of General Petitioners Wales GP of the Year in 2019.

  • I am Clinical Director of the University of Oxford Primary Care and Vaccines Clinical Trials Collaborative, and of the NIHR Community Healthcare Medical Technology and In-Vitro Diagnostics Co-operative.

Chris Butler


I provide additional tutorials for clinical medical students, and I supervise DPhil and post-doctoral students.


I have expertise in clinical trials, cohort studies, qualitative research and analysis of routinely collected data. I promote research that is clinically inspired, aims to improve the quality of primary care, improve the quality of people’s lives, and reduces health inequalities. I led, or helped lead, more than 20 randomised clinical trials, largely in the fields of common infections and health behaviour change. I have published nearly 400 journal articles including trials in the world’s leading general medical journals.

A lot of my research funding has come from the European Union, and many of our studies could only have been done with extensive international clinical and research collaboration supported by far-sighted funders who are committed to improving the evidence to support patient care on a wide scale. I am the Chief Investigator of the National Urgent Public Health Priority community Clinical Trial of interventions for Covid-19 illness (The Principle Trial). I also chair the Prize Advisory Panel of the £10M Longitude Prize for a transformative point-of-care diagnostic to improve the use of antibiotics.

Selected Publications

Christopher C. Butler, Mandy Lau, David Gillespie, Eleri Owen-Jones, Mark Lown, Mandy Wootton, Philip C. Calder, Antony J. Bayer, Michael Moore, Paul Little, Jane Davies, Alison Edwards, Victoria Shepherd, Kerenza Hood, F.D. Richard Hobbs, Mina Davoudianfar, Heather Rutter, Helen Stanton, Rachel Lowe, Richard Fuller, Nick A. Francis, ‘Effect of probiotic use on antibiotic administration among care home residents: a randomized clinical trial’, Journal of the American Medical Association (in press)

Butler C.C., Gillespie D., White P., Bates J., Lowe R., Thomas-Jones E., Wootton M., Hood K., Phillips R., Melbye H., Llor C., Cals J.W.L., Naik G., Kirby N., Gal M., Riga E., Francis N.A., ‘C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations’, The New England Journal of Medicine 381(2) (2019), 111-120 [doi:10.1056/nejmoa1803185]

Butler C.C., van der Velden A.W., Bongard E., Saville B.R., Holmes J., Coenen S., Cook J., Francis N.A., Lewis R.J., Godycki-Cwirko M., Llor C., Chlabicz S., Lionis C., Seifert B., Sundvall P.D., Colliers A., Aabenhus R., Bjerrum L., Jonassen Harbin N., Lindbæk M., Glinz D., Bucher H.C., Kovács B., Radzeviciene Jurgute R., Touboul Lundgren P., Little P., Murphy A.W., De Sutter A., Openshaw P., de Jong M.D., Connor J.T., Matheeussen V., Ieven M., Goossens H., Verheij T.J., ‘Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: an open-label, pragmatic, randomised controlled trial’, The Lancet (12 Dec 2019), pii: S0140-6736(19)32982-4 [doi: 10.1016/S0140-6736(19)32982-4]

Nick A. Francis, Rebecca Cannings-John, Cherry-Ann Waldron, Emma Thomas-Jones, Tom Winfield, Victoria Shepherd, Debbie Harris, Kerenza Hood, Deborah Fitzsimmons, Amanda Roberts, Colin Powell, Micaela Gal, and Christopher C. Butler, ‘Oral Steroids for the resolution of otitis media with effusion in children (OSTRICH): randomised controlled trial’, The Lancet 392 (18 Aug 2018), 557-568 [doi:10.1016/S0140-6736(18)31490-9]

Butler, C. C., Francis, N.A., Thomas-Jones, E., Longo, M., Wootton, M., Llor, C., . . . Pickles, T. (2018), ‘Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness’, The British journal of general practice: the journal of the Royal College of General Practitioners 68(669) (2018), e268-e278 [doi:10.3399/bjgp18x695285]

Butler C.C., Robling M.R., Prout H., Hood, Kinnersley P., ‘The management of suspected acute

viral upper respiratory tract infection in children: a randomised control trial of intranasal sodium cromoglycate versus normal saline’, The Lancet 359 (2002), 2153-58 (32 citations)

Butler C.C., Hood K., Verheij T., Little P., Melbye H., Nuttall J., Kelly M.J., Mölstad S., Godycki-Cwirko M., Almirall J., Torres A., Gillespie D., Rautakorpi U., Coenen S., Goossens H., ‘Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries’, BMJ (23 Jun 2009), 338:b2242

Butler C.C., Simpson S.A., Dunstan F., Rollnick S., Cohen D., Gillespie D., Evans M.R., Health S.L., Alam M.F., Bekkers M.J., Evans J., Moore L., Howe R., Hayes J., Hare M., Hood K., ‘Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial’, BMJ (2012), d8173-d8173

Butler C.C., Simpson S., Hood K., Cohen D., Pickles T., Spanou C., McCambridge J., Moore L.,

Randell E., Alam M.F., Kinnersley P., Edwards A., Smith C., Rollnick S., ‘Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial’, BMJ (2013), 346:f1191

Butler C.C., Rollnick S., Maggs Rapport F., Pill R.M., Stott N.C.H., ‘Understanding the culture of

prescribing: A qualitative study of general practitioners' and patients’ perceptions of antibiotics for sore throats’, BMJ 317 (1998), 637-42

Professor Butler

Most antibiotics are prescribed in primary medical care, and many of these prescriptions do not benefit patients… there have been virtually no trials of point of care tests that measure impact on clinician behaviour, patient behaviour and patient outcomes… Ours is the first trial of biomarker guided management of AECOPD in ambulatory care, and has found an effect that should be practice-changing.