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Pharmacy First data have been included in the UK Health Security Agency’s (UKHSA’s) report on antimicrobial resistance (AMR) for the first time.
The data, published in the ‘English surveillance programme for antimicrobial utilisation and resistance’ report for 2024/2025 on 13 November 2025, show that 80% of antimicrobials were prescribed in primary care in 2024, 4% of which through Pharmacy First.
During the first 11 months of the Pharmacy First service — February to December 2024 — more than 1.2 million antimicrobial items were dispensed in total.
The most dispensed antimicrobials under the Pharmacy First service pathways were phenoxymethylpenicillin (37%), nitrofurantoin (36%), flucloxacillin (12%) and amoxicillin (7%).
Overall, the UKHSA said the report showed that NHS antibiotic prescribing levels were lower in 2024 than 2019 pre-pandemic levels, at 13.96 items per 1,000 inhabitants, compared with 14.21 items per 1,000 inhabitants.
However, private dispensing in community pharmacies more than doubled since 2019, from 1.95 items per 1,000 inhabitants to 3.93 items per 1,000 inhabitants.
Overall, primary care antibiotic use (NHS and private non-NHS) rose by almost 11% between 2019 and 2024, reflecting the increase in private prescriptions, with 22% of antibiotics in 2024 dispensed through the private sector.
The UKHSA report also revealed that antibiotic-resistant infections had risen by 13% between 2019 and 2024, with 20,484 cases reported in 2024, equating to nearly 400 cases per week.
People living in the most deprived communities were found to have a 47% higher rate of resistant bacteraemia compared with those in the least deprived areas.
Speaking to The Pharmaceutical Journal, Diane Ashiru-Oredope, lead pharmacist for healthcare-associated infections and AMR at the UKHSA, said: “Pharmacy professionals across all sectors are essential partners to us in tacking AMR and managing infections.
“They have a key role in ensuring appropriate use of antibiotics, which includes prescribing or issuing, for example, through Pharmacy First, but also in the screening of prescriptions. So when prescriptions are sent by the GP or other healthcare professionals, or within hospitals, [ensuring] those prescriptions are appropriate for the patient.”
Ashiru-Oredope highlighted that the ‘Keep antibiotics working’ campaign will launch again during World AMR Awareness Week, which begins on 18 November 2025.
“The key messages are for the public not to use antibiotics when they’re not needed, to listen to healthcare professionals, and also safe disposal of medicines through pharmacy teams, rather than throwing them into the bin,” she said.
Discussing the disparity in antibiotic-resistant infections between those in the least and most deprived areas, Ashiru-Oredope said the data showed no difference to disparities for other health conditions, such as diabetes.
“What this highlights is that there are broader issues that may be causing these disparities. However, this does not absolve us of the responsibility to take actions to support these groups.”
She said that the UKHSA is working alongside NHS England and the Department of Health and Social Care on the national action plan for AMR health inequalities. “This is a specific outcome that we want to try and make sure that we take action on.”
Giving examples of these actions, Ashiru-Oredope said the UKHSA will increase its data, and the granularity of data, on the disparities, “because that enables us to understand where to focus attention”.
“We will also look at the evidence and develop interventions. We’ve already started that process by looking at systematic reviews, particularly across the usual areas of factors associated with health inequalities, but also the inclusion of health groups. Linked to that is developing a toolkit that will support healthcare professionals to be able to take action.”
