The latest national surveillance data, published in the UK Health Security Agency (UKHSA) annual conference in Leeds today, showed that an estimated 58,224 people in England had antibiotic-resistant infections in 2022 – a 4% increase from 2021 (55,792). Deaths due to serious antibiotic-resistant infections also increased from 2021 to 2022 (2,110 to 2,202).
Antibiotic use in England declined from 2014 to 2020, with the largest drop in 2020 related to the epidemic. However, recent data now show a reversal of this downward trend, with antibiotic use increasing in all settings (except dental) in 2022. Total prescriptions are up 8.4% in 2022 compared to 2021, though remain below 2019’s pre-pandemic levels.
Inappropriate and excessive antibiotic use increases the risk of emergence of antibiotic-resistant bacteria and increases the number of deaths associated with these infections.
The proportion of bloodstream infections resistant to one or more antibiotics has remained stable (1 in 5) since 2018, but there is concern about the rise of antibiotic resistance in some bacteria.
Klebsiella pneumoniae – a cause of sepsis – is becoming increasingly resistant to various antibiotics traditionally used as first-line treatment, especially third-generation cephalosporins (from 13.5% resistant in 2018 to 17.4% in 2022) and piperacillin (Tazomac with 155% . to 19.6%).
This year’s report provides additional analysis of differences in the burden of antibiotic resistance between different populations in England. Asian or Asian British ethnic groups had almost double the proportion of antibiotic resistant infections (34.6%) than white ethnic groups (18.7%).
Antibiotic resistance occurs naturally, but inappropriate use and overuse of antibiotics can accelerate this process. Antibiotic-resistant bacteria are less likely to respond to treatment, leading to serious complications, including bloodstream infections, sepsis, and hospitalization.
People with bacterial infections resistant to one or more antibiotics are more likely to die from their infections than those with antibiotic-sensitive infections. This is why it is important to take antibiotics only when they are prescribed and necessary for the condition.
Professor Dame Jenny Harris, Chief Executive UKHSAsaid:
Antimicrobial resistance is not a crisis of the future, but it is very much with us now. We hope that if we get a bacterial infection, an antibiotic will be available to treat us – but sometimes, in the meantime, that’s simply impossible. Failure to act will only reduce the availability of life-saving treatments and reduce our ability to reduce infections, perhaps affecting those in the poorest social ills.
There are 2 things everyone can do to help the antibiotics work. First you can help reduce or prevent infection by taking simple steps – staying away from vulnerable people if you feel sick, washing your hands regularly and keeping rooms ventilated. It’s not just about protecting your own health – it’s about helping everyone in our community.
Second, only take antibiotics if you are told to do so by a healthcare professional. Don’t save anything for later or share with friends and family. Antibiotics will not work for viruses such as colds, flu or COVID-19. Treat antibiotics with respect and they will be there to help us all in the future.”
Professor Camilla Hawthorne, Chair of the Royal College of General Practitioners (RCGP), said:
Antimicrobial resistance (AMR) is one of the greatest public health challenges we face and GPs and our teams have worked incredibly hard to reduce it for decades, so it is very worrying to see this increase. One reason may be the temporary shift in thresholds during recent infectious outbreaks, such as the strep A outbreak last Christmas.
Antibiotics are vital medicines and we need them to remain effective – and everyone from healthcare and public health professionals to patients has a responsibility to help ensure that antibiotics are used responsibly and carefully. GPs are always looking for ways to safely reduce the use of antibiotics, and will only prescribe them in accordance with the guidelines and if we think they will benefit the patient in front of us.
The RCGP worked with UKHSA To develop our popular Target Antibiotic Toolkit to support GPs and our teams in the appropriate prescribing of antibiotics.”
There are a number of reasons behind the increase in prescriptions, one of which is likely related to reduced immunity and exposure to infections during the Covid-19 pandemic, which may be based on increased transmission of co-circulating infections, namely:
- influenza (flu)
- Respiratory syncytial virus (RSV)
- Group A Streptococcus (GAS)