National surveillance data published by the UK Health Security Agency (UKHSA) has revealed that the number of antibiotic-resistant infections remains worryingly high.

The estimated number of deaths in people with a antibiotic-resistant infection also increased from 2,041 deaths in 2023 to 2,379 deaths in 2024, an increase of 338 deaths in one year.

The ‘English surveillance programme for antimicrobial utilisation and resistance'(ESPAUR) report offers vital insights into the scale of the problem faced by the UK as it strives to meet the challenging goals and targets set out in the UK National Action Plan 2024 to 2029.

Antibiotic-resistant bacteria of any kind are less likely to respond to treatment, causing serious complications, including bacteraemia, 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-susceptible infection.

Limiting antibiotic use to where it is most needed

Between 2019 and 2024, NHS primary care antibiotic use decreased (from 14.21 to 13.96 Defined Daily Dose, or DID), while private dispensing in community pharmacies nearly doubled (0.37 to 0.66 DID).

Overall, primary care antibiotic use (NHS and private non-NHS) rose by 0.27% between 2019 and 2024, reflecting the rise in private prescriptions. By 2024, 4.5% of primary care antibiotics were dispensed through the private sector.

The report shows that most antibiotic-resistant bloodstream infections in the last 6 years (65%) were caused by E. coli – a common cause of urinary tract infections.

Cases of bacteraemia caused by antibiotic-resistance, a life-threatening infection where bacteria circulate in the blood, have increased by 9.3% since 2023, rising from 18,740 cases in 2023 to 20,484 cases in 2024.

Vulnerable populations include the over-45s and those living in ‘deprived communities’

While anyone can acquire a resistant infection, adults over the age of 45 years continue to be the most at risk, accounting for 90% of cases. Nearly half (46.2%) were detected in people over 74. Research suggests risk increases with age because individuals are more likely to develop multiple medical conditions as they get older and have more exposure to medical interventions.

For the first time, the ESPAUR report includes data on antibiotic prescriptions from the new Pharmacy First service, alongside other primary care services including general practice and dentistry. The majority of antibiotics prescribed in 2024 were in primary care (79.6%), within which Pharmacy First accounted for 4%. Antibiotic prescribing in general practice and dentistry remain below 2019 levels.

Within the NHS overall antibiotic use in 2024 was 2% lower than the 2019 pre-pandemic baseline, suggesting a return to more stable prescribing patterns. However, among certain groups prescribing rates in 2024 remain above pre-pandemic levels, for example in children and young people.

Data for 2024 highlights 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 the most deprived communities had a 47.2% higher rate of resistant bacteraemia compared to those in the least deprived areas. The difference in rate between the most and least deprived populations has widened from a 29% difference in 2019 to a 47% difference in 2024.

Professor Susan Hopkins, Chief Executive of UKHSA, said:

“Antibiotic resistance is one of the greatest health threats we face.

“More people than ever are acquiring infections that cannot be effectively treated by antibiotics. This puts them at greater risk of serious illness and even death, with our poorest communities hit the hardest.

“We are united with partners globally in finding new ways to tackle this complex problem.

“This includes using antibiotics in a way that doesn’t contribute to the spread of resistance, researching new types of treatments and preventing infections from occurring in the first place.

“It’s positive that we’ve seen antibiotic use fall in England within the NHS but we need to go further, faster.

“Please remember to 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. If you have leftover antibiotics, please bring them to a pharmacy for appropriate disposal.
“It’s also important to take up the vaccinations you are eligible for to help stop infections in the first place.”