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21.11.16

Antibiotic prescriptions drop, but ‘global threat’ of resistant infections continue to grow

Antibiotic reduction initiatives have been hailed as a success as the latest annual report from Public Health England (PHE) shows that a decline in antibiotic prescription has occurred in all settings for the first time.

In 2014-15, total antibiotic prescribing declined by 4.3%, from 22.9 defined daily dose (DDD) per 1,000 inhabitants per day to 21.8.

Antibiotic prescription in primary care has been declining since 2011, but the new report marks the first time that prescriptions have declined in hospitals and dentistry as well.

Dr Susan Hopkins, lead author and healthcare epidemiologist at PHE, said: “The overall decrease in the number of antibiotics being prescribed is great news but we can’t become complacent; there is still a lot of work to be done.”

The NHS has committed to reducing antibiotic prescription amid global concerns that increased antimicrobial resistance could make it harder to treat patients.

However, the PHE report showed that antibiotic resistant infections continued to grow, in line with rates seen in recent years.

E. coli bloodstream infections that were resistant to third-generation cephalosporins increased by 11%, and infections resistant to ciprofloxacin increased by 5.2%.

In addition, there was wide variation in the rates of resistance to antibiotics across England. For example, trimethoprim resistance in Gram-negative urinary tract infection (UTI) ranged from 16.3% to 66.7% by CCG, although PHE said this may be related to inconsistencies in the testing process.

Professor Dame Sally Davies, chief medical officer, called antimicrobial resistance “the biggest threat to global health”, arguing that it can “halt the progress of over a century of modern medicine”.

“Before antibiotics and vaccines, around 40% of all deaths were due to infections, now it is just 7%. We do not want to see this reversed so we must do all we can to fight drug resistant infections,” she added.

“Reducing inappropriate antibiotic prescribing is a key element in the fight against drug resistant infections and I am really pleased to see staff across the entire NHS making positive changes. We all have a role to play, and preventing infection through good hygiene and not demanding antibiotics when they are not clinically justified are just two of the ways we can help.”

Dr Mike Durkin, NHS England national director of patient safety, hailed the PHE results as a “fantastic step in the right direction”, attributing it to the “huge efforts” of healthcare staff and local commissioners.

He added that NHS England would introduce new national incentive schemes for appropriate prescribing of antibiotics in 2017-19.

(Image c. Free Images)

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