The number of people with antibiotic resistant infections in England has increased “substantially” over the past five years, according to a new report.
At the same time, antibiotic consumption in the NHS has also gone up by nearly 7%, which is thought to be contributing to resistance due to inappropriate prescriptions.
The report, published today by Public Health England, has called for “continued focus” from clinicians who prescribe, administer and dispense antibiotics to reduce their use.
“It is vital we ensure prescriptions are given only when they will make a difference to patient outcomes”
Health officials said it would take “a long time” before interventions would begin to show significant improvements at a national level.
New figures for last year collected by PHE found rates of bloodstream infections caused by bacteria Escherichia coli and Klebsiella pneumonia went up between 2010 and 2014.
Infections from Klebsiella pneumonia increased by around 20%, while those caused by Escherichia coli rose by around 15%.
Resistance among a range of antibiotics used to tackle these infections either increased or remained the same compared to 2010, meaning overall that increasing numbers of people are not responding to their use.
However, Streptococcus pneumoniae bloodstream infections reduced by 23% over the five years. PHE said this may be related to increased pneumococcal vaccination rates.
The data was revealed in PHE’s second report on antibiotic prescribing and resistance under its English Surveillance Programme for Antimicrobial Utilisation and Resistance, launched in 2013.
“Reducing prescribing is a long journey and it will take time before the effects of our various interventions are reflected in surveillance data”
The report showed that in 2014, the majority of antibiotics in England – 74% – were prescribed in general practice, with 11% for hospital inpatients, 7% for hospital outpatients and the remainder in dental practices or other community settings.
In primary care, although the number of individual antibiotic prescriptions decreased, overall consumption went up by nearly 7% between 2011 and 2014, suggesting longer courses or higher doses were being prescribed.
However, the use of broad-spectrum antibiotics – those effective against a wide range of bacteria and more likely to drive resistance – has reduced in primary care, to around 8% of all antibiotic prescriptions.
Meanwhile, in secondary care, prescribing to hospital inpatients increased significantly by 11% and to hospital outpatients by 8% between 2011 and 2014.
In particular, broad spectrum antibiotics increased and accounted for a third of all of antibiotic prescriptions in NHS trusts in 2014.
Prescriptions for two that should be a last resort for clinicians to use – carbapenems and piperacillintazobactam – went up by 36% and 55%, respectively, from 2010 to 2014.
NHS England’s director of patient safety Dr Mike Durkin urged clinicians and patients to “do all they can to behave as responsible stewards of the use of antimicrobial medications”.
Dr Susan Hopkins, lead author and healthcare epidemiologist at PHE, said: “Whilst this report shows that overall antibiotic prescribing increased in 2014, we must remember that reducing prescribing is a long journey and it will take time before the effects of our various interventions are reflected in surveillance data.
“It is vital that we tackle antibiotic prescribing across the population and ensure prescriptions are given only when they will make a difference to patient outcomes,” she added.