THE latest national surveillance data announced at the UK Health Security Agency annual conference in Leeds today (Wednesday, 15 November 2023), shows that an estimated 58,224 people in England had an antibiotic-resistant infection in 2022 - a rise of 4% since 2021 (55,792). Deaths due to severe antibiotic-resistant infections also increased from 2021 to 2022 (from 2,110 to 2,202). 
 

Antibiotic resistance is once again on the increase following declines in the pandemic, with more dangerous strains of bacteria spreading in our communities and in hospitals. 
 

Antibiotic use in England declined from 2014 to 2020, with large drops in 2020 related to the pandemic. However, the latest data now shows a reversal in this downward trend, with antibiotic use in all settings (apart from dental) increasing in 2022. Total prescribing rose by 8.4% in 2022 compared with 2021, although remains below 2019 pre-pandemic levels. 
 

Inappropriate and excessive antibiotic use increases the risk of the emergence of antibiotic-resistant bacteria and the associated increase in deaths related to these infections. 
 

This year’s report provides additional analysis of differences in antibiotic resistance burden in England in different populations and identifies geographical variation in the levels of antibiotics prescribed across England.
 

The North West region reported the second highest AMR burden rate per 100,000 population (32.9 per 100,000 population) behind London (39.2 per 100,000 population). This equates to 2,444 resistant bloodstream infections in the North West during 2022.
 

The total number of bloodstream infections in the North West increased in 2022 with 12,067 infections compared to 11,248 in 2021 (162.6 vs 152.7 per 100,000).
 

In the North West, total antibiotic consumption increased by 8.3% in 2022 compared to 2021, having almost returned to pre-pandemic levels.
 

The report also identified that the North West has consistently had the greatest levels of antibiotics prescribed across the country, measured by “defined daily doses”.  In response to these consistently high rates in the region, UKHSA North West and NHS England North West delivered antimicrobial stewardship training (Treat Antibiotics Responsibly, Guidance Education and Tools) for primary care prescribers across the North West during 2023.  This training will enable clinicians to reduce inappropriate prescribing of antibiotics in general practice, where 72% of antibiotics are prescribed by NHS clinicians.
 

There was marked regional variation in prescribing of antifungals in England. In 2022, and for the previous 4 years, the North West had the highest prescribing rate.
 

This year’s report provides additional analysis of differences in antibiotic resistance burden in England in different populations. Of all bloodstream infections detected, Asian or Asian British ethnic groups had almost double the proportion of antibiotic-resistant infections (34.6%) compared to 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, causing serious complications, including bloodstream infections, sepsis and hospitalisation. People who get a bacterial infection that is resistant to one or more antibiotics are more likely to die from their infection compared to those who have an antibiotic-sensitive infection. This is why it is important to take antibiotics only when they are prescribed and necessary for the condition. 
 

Dr Will Morton, Consultant in Health Protection from UKHSA, said:- “Antibiotics are essential to treat serious bacterial infections, such as meningitis, pneumonia and sepsis but inappropriate use or overuse will mean they stop working against life-threatening conditions. In the absence of effective antibiotics, cancer treatments and common surgeries like caesareans would become very high-risk procedures and for many people, could lead to infections that cannot be treated and may become fatal.  Taking antibiotics when you don’t need them puts you and your family at risk of developing infections which in turn cannot be easily treated with antibiotics. Antibiotics work by killing bacteria, so they won’t help relieve the symptoms of cold, flu or COVID-19 or treat these viral illnesses – please trust your healthcare professional, take antibiotics only as prescribed, never share with others and don’t save for later.”
 

Dame Jenny Harries, Chief Executive at UKHSA, added:- “Antimicrobial resistance is not a crisis of the future, but 1 that is very much with us right now. We expect that if we get a bacterial infection, an antibiotic will be available to treat us – but sometimes, already, that is simply impossible. Unless action is taken the availability of life-saving treatments will only diminish and our ability to drive down infections will decrease, most likely impacting those in the poorest social circumstances worst.
 

“There are 2 things everyone can do to help keep antibiotics working. 1st, you can help reduce or prevent infections in the 1st place by taking simple steps – staying away from vulnerable people if you are feeling unwell, washing your hands regularly and keeping rooms ventilated. This isn’t just about protecting your own health – it’s about helping everyone in our communities. 2nd, only take antibiotics if you have been told to do so by a healthcare professional. Do not save some for later or share them with friends and family. Antibiotics will not work for viruses such as cold, flu or COVID-19. Treat antibiotics with respect and they will be there to help us all in the future.”