National surveillance data from the UK Health Security Agency (UKHSA) reveal a worrying rise in antibiotic-resistant infections, with nearly 400 new cases reported each week in 2024. Bacteraemia caused by resistant bacteria increased by 9.3% compared to 2023, rising from 18,740 cases to 20,484, while deaths associated with resistant infections also grew from 2,041 to 2,379 over the same period. The majority of bloodstream infections over the past six years (65%) were caused by E. coli, a common source of urinary tract infections.
The ESPAUR report underscores the urgent challenge posed by antibiotic resistance in the UK. Resistant infections are harder to treat, often leading to severe complications such as sepsis and hospitalization. Individuals infected with antibiotic-resistant bacteria have a higher risk of dying within 30 days compared to those with susceptible infections. Although antibiotic resistance occurs naturally, its spread can be mitigated by reducing unnecessary antibiotic use and implementing effective public health measures.
From 2019 to 2024, NHS primary care antibiotic use declined slightly, from 14.21 to 13.96 defined daily doses per 1,000 inhabitants per day (DID), but private prescriptions more than doubled, resulting in an overall 10.7% increase in primary care antibiotic use. Around 22% of antibiotics in 2024 were dispensed through private channels, reflecting shifting prescribing patterns outside the NHS.
UKHSA Chief Executive Professor Susan Hopkins highlighted that antibiotic resistance is among the greatest health threats in the UK, disproportionately affecting the most vulnerable communities. She emphasized the importance of responsible antibiotic use, completing prescribed courses, and ensuring vaccinations are up to date to prevent infections. Older adults remain most at risk, with 90% of resistant infections occurring in people over 45 and nearly half in those over 74, largely due to multiple health conditions and increased medical exposure.
For the first time, ESPAUR included data from the Pharmacy First service alongside general practice and dentistry, showing that most antibiotics were still prescribed in primary care, with Pharmacy First accounting for 4%. General practice and dentistry prescribing remained below 2019 levels. Health Minister Zubir Ahmed stressed that tackling antimicrobial resistance (AMR) is a public health priority and requires equitable approaches to support communities disproportionately affected.
NHS England and the MHRA emphasized a multi-pronged approach, including infection prevention, rapid diagnostic testing, and the development of new antibiotics, vaccines, and treatments such as microbiome therapies and bacteriophage applications. Collaborative efforts using real-world data from hospitals, pharmacies, GPs, and environmental sources aim to identify emerging threats quickly and implement timely interventions.
Despite a 2% reduction in NHS antibiotic use compared to pre-pandemic levels, prescribing rates for children and young people remain above baseline. The data also highlight growing inequalities: residents in the most deprived areas have a 47.2% higher rate of resistant bacteraemia compared to those in the least deprived areas, an increase from a 29% difference in 2019. UKHSA continues to investigate these disparities and develop targeted interventions to protect all communities and preserve the effectiveness of life-saving antibiotics.
