Healthcare professionals in England have exceeded Government targets to reduce antibiotic prescribing years ahead of schedule, figures suggest.
A report from the UK Health Security Agency (UKHSA), published last week, found total antibiotic use in England has fallen by 15.1% between 2017 and 2021.
The Government’s National Action Plan goal was to reduce prescribing by 15% by 2024 from a 2014 baseline.
But public health experts warned the downward trend may not be sustained unless clinicians continue to use antibiotics appropriately and continue to drive down infections overall.
Earlier this month, NHS England asked GPs to consider reviewing their prescribing of antibiotics as part of a new drive to tackle antimicrobial resistance.
Figures from 2021 also show antibiotic resistant infections have started to rise once more, although rates are still below pre-pandemic levels.
There were 148 severe antibiotic resistant infections a day in England on average in 2021, an increase of 2.2% from the previous year.
It comes as new guidance has been issued by NHS England on managing incidents of ceftriaxone-resistant Neisseria gonorrhoeae.
Alongside marked increases of gonorrhoea diagnoses in recent years, there have been nine reports of ceftriaxone-resistant disease in England in 2022 up from two or three cases in 2018, 2019 and 2021, the guidance said.
While sustained local transmission of highly resistant strain FC428 has not been reported to date in the UK, the ease with which it has spread internationally attests to how rapidly gonorrhoea might become untreatable, the guidance warns.
GPs need to be aware of the possibility of resistance in a patient who has persistent symptoms after ceftriaxone monotherapy and suspected cases should be reported directly to UKHSA, where a national team can risk assess and coordinate the response.
Speaking on the risks of antimicrobial resistance, Professor Susan Hopkins, chief medical advisor at UKHSA, said: ‘We are already seeing resistance emerge to our very newest antibiotics – innovation to find new treatments will only succeed if we use what we have responsibly.
‘Overuse of antibiotics will mean they stop working against life threatening conditions such as sepsis.’
Professor Dame Jenny Harries, UKHSA chief executive added: ‘As we emerge from the Covid-19 pandemic, this is a pivotal moment to maintain focus on the “silent pandemic” of antibiotic resistance through our extensive surveillance and antibiotic stewardship activities.’
She said over two fifths of E. coli bloodstream infections are resistant to co-amoxiclav, a key antibiotic used in the treatment of serious infections in hospital and in newer antibiotic therapies such as cefiderocol there are also signs of resistance developing.
A new randomised controlled clinical trial led by the University of Bristol will assess whether ‘point-of-care’ testing for respiratory infections could further reduce antibiotic prescribing in general practice.
The swab tests can give clinicians same-day results to guide prescribing decisions say researchers but the trial will investigate whether ‘they are a good use of scarce NHS funds before they are introduced into routine care’, said study lead Professor Alastair Hay, a GP and professor of primary care.
READERS' COMMENTS [1]
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Lets get more perspective based on this report.
72% of all antibiotics prescribed in primary care, but primary care sees 90% of all patient contacts, so per contact has a significantly lower rate of prescribing (by my calculation secondary care prescribing is three times higher than primary care on a per patient basis).
Per the report:
“Total antibiotic use in NHS acute hospital trusts, measured using hospital admissions as the
denominator, decreased by 5.2% between 2017 and 2021. This was driven by reductions in outpatient prescribing which decreased by 18.3% during that period, whereas inpatient prescribing increased by 3.0%.”
Of course, we know from covid outpatient activity all but stopped, so of course prescribing went down.
Inpatient prescribing went up.
GPs prescribing less, hospital prescribing more.
And yet, GPs get all the flack for antibiotics use.