Antibiotic prescribing increases by more than 8% in one year

Antibiotic prescribing rose by 8.4% in 2022, compared with the previous year, figures published by the UK Health Security Agency (UKHSA) have shown.

The data, published on 15 November 2023, also show a 4.0% increase in antibiotic-resistant infections in England from 2021 to 2022, as well as an increased number of antimicrobial resistance (AMR)-associated deaths.

The national surveillance data shows that an estimated 58,224 people in England had antibiotic-resistant infections in 2022, compared with 55,792 in 2021. The data also show a subsequent increase in the estimated number of AMR-associated deaths, from 2,110 in 2021 to 2,202 in 2022.

The 2022 infection figures are still below the 2018 figures — the baseline for the government’s five-year AMR action plan, which was published in January 2019.

However, antibiotic-resistant infections have been on the rise compared with 2020, when the COVID-19 pandemic began.

The UKHSA also reported that the number of antibiotic prescribing prescriptions had increased by 8.4% in 2022, compared with 2021. Antibiotic use in England fell from 2014 to 2020.

Speaking at a UKHSA webinar on 13 November 2023, Colin Brown, interim director of emerging infections at the UKHSA, said: “Unfortunately, we have once again seen a rise in antibiotic-resistant infections in 2022.

“And we’ve not yet made a dent in the proportion of infections that are resistant [to one or more antibiotics] — that remains quite resolute at about one in five bloodstream infections [since 2018],” he added.

The surveillance data show that, between 2019 and 2022, the number of bloodstream infections caused by candida increased by 23.2%, along with an increased proportion of infections resistant to fluconazole — a first-line treatment option for fungal infections.

In addition, there were growing concerns on the antibiotic resistance of some bacteria, such as Klebsiella pneumoniae — a common cause of sepsis.

Data show an increased proportion of resistance against first-line treatment options, including cephalosporins — from 13.5% in 2018 to 17.4% in 2022 — and piperacillin with tazobactam — from 15.1% to 19.6% over the same period of time.

“Looking at who is most impacted, older adults — those aged over 64 years — have the highest rates of bloodstream infections caused by resistant pathogens, followed by the very young children aged under one year.”

“We also know that those who are Asian or British Asian are more likely to be impacted. We are currently working to understand the factors behind this, and what we can do to tackle any trends that we have identified,” he added.

Also speaking at the webinar, Diane Ashiru-Oredope, lead pharmacist for healthcare-associated infections and antimicrobial resistance at the UKHSA, said that the organisation was working to strengthen surveillance for identifying and developing new ways to tackle AMR.

“It is also important that antimicrobials are only taken if they’ve been advised by a healthcare professional, and that they’re not saved for later or shared with other people, friends and family,” she said.