National surveillance data published by the UK Health Security Agency show that antibiotic-resistant infections in 2023 surpassed pre-pandemic levels. There were an estimated 66,730 serious antibiotic-resistant infections in 2023, compared to 62,314 in 2019.
The English Surveillance of Antibiotic Prescribing and Utilisation Report (ESPAUR) shows that the majority of antibiotic resistant bloodstream infections in the last five years (65%) were caused by Escherichia coli.
Antibiotic resistant bacteria of any kind 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 within 30 days compared to those who have an antibiotic sensitive infection.
Antibiotic resistance occurs naturally but managing antibiotic consumption and only using them when appropriate is essential to limiting the emergence of antibiotic-resistant bacteria and associated deaths related to these infections.
Data for 2023 also highlight a widening gap between people living in the most and least deprived areas of society when it comes to chances of acquiring an antibiotic-resistant infection. People living in more deprived communities were 42.6% more likely to have an antibiotic-resistant infection, compared to those in the least deprived areas. This is higher than in 2019 (29.4%). Overall, from 2019 to 2023, rates of resistant infections in the most deprived populations of England have increased by 9.5% in 2023.
Most antibiotic-resistant infections are in white ethnic groups (89.8%), while Asian or Asian British ethnic groups have the highest proportion of antibiotic resistant infections (39.4%). UKHSA is working with partners to understand the reasons for these differences and design interventions to tackle them.
Professor Dame Jenny Harries, Chief Executive of UKHSA, said: “Increasingly the first antibiotics that patients receive aren’t effective at tackling their infections. That’s not just an inconvenience – it means they are at greater risk of developing a severe infection and sepsis. Our declining ability to treat and prevent infections is having an increasing impact, particularly on our poorest communities.”
Antibiotic use also rose in 2023 by 2.4%, compared to 2022, and prescribing levels are now in line with those seen in 2019. The increases were across the majority of antibiotic groups, with penicillins accounting for the most frequently prescribed antibiotic group in primary and secondary care.
This latest data provide important insight into the scale of the problem presented by antimicrobial-resistnce (AMR) and will help guide the goals set out in the UK AMR National Action Plan 2024-2029 earlier this year. This includes ambitions to reduce total antibiotic use in human populations by 5% from the 2019 baseline and investments in new tools and technologies to develop long-lasting solutions.
The UKHSA is working with the Medicines and Healthcare products Regulatory Agency (MHRA) on innovative ways to combat antibiotic resistance by developing quality standards to support the research and development of novel therapeutics and treatments to tackle antibiotic resistance in the UK and around the world.