Antibiotic Resistant Bloodstream Infections up 35%

Nicky Broyd

October 23, 2018

Public Health England (PHE) has published its fifth annual report into antimicrobial utilisation and resistance in England.

The English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report says despite a continued reduction in antibiotic prescribing, driven by primary care, there has been a rise in antibiotic-resistant infections. The estimated number of bloodstream infections caused by pathogens resistant to one or more key antibiotics increased from 12,250 in 2013 to 16,504 in 2017, a rise of 35%.

In 2017 most antibiotics were prescribed by GPs (72.7%), followed byhospital inpatients (11.5%), hospital outpatients (7.1%), dental practices (5.2%) and other community settings (3.5%).

The most commonly prescribed antibiotics in England in 2017 were penicillins (44.6%) tetracyclines (22.2%) and macrolides (14.7%).

Operations and Cancer Treatment

The ESPAUR report highlights how without antibiotics more than 3 million common surgical operations and cancer treatments could become life-threatening.

It says approximately 1 in 3 surgical procedures require antibiotics to be given prior to or during surgery to prevent infections. The four most common operations requiring antibiotic prophylaxis are caesarean section, hip replacement and knee replacement, gall bladder removal, and gastrointestinal tract procedures.

The report also says people undergoing cancer treatment are much more vulnerable if antibiotics don't work because their use is critical to prevent and treat infections.  

Professor Paul Cosford, medical director, Public Health England said in a statement: "It's concerning that, in the not too distant future, we may see more cancer patients, mothers who've had caesareans and patients who've had other surgery facing life threatening situations if antibiotics fail to ward off infections.

"We need to preserve antibiotics for when we really need them and we are calling on the public to join us in tackling antibiotic resistance … and only taking antibiotics when necessary."  

Chief Medical Officer for England, Professor Dame Sally Davies, said: "The UK has made great efforts in recent years to reduce prescribing rates of antibiotics, however there continues to be a real need to preserve the drugs we have so that they remain effective for those who really need them and prevent infections emerging in the first place."

Public Information Campaign

In order to continue to get the message about antibiotic resistance across to the public PHE's 'Keep Antibiotics Working' campaign, including posters and a TV ad, is returning.

An Ipsos MORI Capibus Survey, 'Attitudes towards antibiotics, 2017', showed that 38% of people questioned expected an antibiotic from a doctor's surgery, NHS walk-in centre or 'GP out of hours' service when they visited with a cough, flu or a throat, ear, sinus or chest infection.  

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "GPs are already doing an excellent job at reducing antibiotics prescriptions, but we often come under considerable pressure from patients to prescribe them.

"We need to get to a stage where antibiotics are not seen as a 'catch all' for every illness or a 'just in case' back-up option – and patients need to understand that if their doctor doesn't prescribe antibiotics it's because they genuinely believe they are not the most appropriate course of treatment.

"It's crucial that we continue to get this message out, which is why we're pleased to support Public Health England's Keep Antibiotics Working campaign to make sure we can carry on delivering safe, effective care to our patients both now and in the future."


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