Antibiotic consumption in East Midlands continues to rise leading to more resistant infections

Data published by the UK Health Security Agency recently shows that antibiotic resistant infections in 2023 surpassed pre-pandemic levels.

The English Surveillance of Antibiotic Prescribing and Utilisation Report (ESPAUR) shows there were an estimated 66,730 serious antibiotic resistant infections in 2023, compared to 62,314 in 2019.

In the East Midlands, the number of people taking antibiotics also increased by 3.7% across healthcare settings, from 16.1 people a day in every 1,000 taking antibiotics in 2022 to 16.7 in every 1,000 in 2023.

The report also shows the majority of antibiotic resistant bloodstream infections in the last five years (65%) were caused by E. coli – a common cause of urinary tract infections, diarrhoea, vomiting and fever.

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.

Dr Ben Rush, Consultant in Health Protection and lead in Anti Microbial Resistance for UKHSA East Midlands, said: “Increasingly the first-line 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.

“While we work with partners to innovate new approaches and life-saving treatments, there are steps everyone can take. Take up the vaccinations you are eligible for, to help stop infections in the first place. Only take antibiotics if you have been told to do so by a healthcare professional. Do not save some for later or share them with friends and family.

“This isn’t just for your own health - it’s about protecting everyone in our communities and future generations.”

Data for 2023 also highlighted 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.

Nationally, 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. Most prescriptions (79.7%) were in primary care through a GP or pharmacy.

This latest data provides important insight into the scale of the problem we are facing and will help guide the goals set out in the new 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.

Minister for Public Health and Prevention Andrew Gwynne said: “This report lays bare the devastating impact of antimicrobial resistance (AMR) in the UK and around the world. This is an urgent global threat and one we are tackling through our ambitious AMR national action plan. It is clear this emergency cannot be tackled by one nation alone - that is why we are working tirelessly with partners to implement the commitments made by global leaders on AMR at this year's United Nations General Assembly." 

Patient and campaigner, Caroline Sampson, explains how an antibiotic resistant infection has impacted her life. She said: “For 8 and a half years, I have had a chronic urinary tract infection (UTI). No form of antibiotics has successfully treated it. It has derailed by life in every possible way. 

“I can no longer enjoy simple pleasures like eating out, going to the theatre or inviting friends over. The daily symptoms are debilitating and painful. Trying to accomplish the smallest task takes a huge amount of effort. The impact on my mental health has been enormous and I live with daily anxiety that the infection could develop into Urosepsis. 

“I just want my life back. The threat of antibiotic resistant infections to us all cannot be underestimated.”