Antibiotic-resistant infections increasing amidst rise in non-GP prescribing

The number of antibiotic-resistant infections continues to rise in England, amidst changing patterns of prescribing, the UK Health Security Agency has reported.

An average of 400 new resistant infections were reported a day in 2024, the English Surveillance of Antibiotic Prescribing and Utilisation Report (ESPAUR).

Antibiotic use in the NHS is 2% below 2019 pre-pandemic levels with GPs issuing 1.2 million fewer antibiotic prescriptions between April 2024 to March 2025 than the previous 12 months.

But there has been a large rise in private antibiotic prescribing, the report warned, accounting for 22% of antibiotics dispensed in primary care in 2024, the report found.

This year’s report also includes data from Pharmacy First which shows in the 11 months from February 2024 until the end of the year, 1.3 million antibiotics were prescribed through the scheme accounting for 4% of those issued in primary care.

Between February and December 2024, supply of phenoxymethylpenicillin to those aged 5 to 17 years via Pharmacy First accounted for 16.5% of all phenoxymethylpenicillin supplied through the scheme and general practice.

And a clear reduction in GP practice dispensing of nitrofurantoin, alongside increased supply through Pharmacy First indicates a shift in uncomplicated UTI management from GPs to community pharmacies, the report found.

While the increase in antibiotic supply through the Pharmacy First service is notable, it should ‘be interpreted with caution and in the context of broader changes in how patients access care’, the authors noted.

Overall, cases of bacteraemia caused by antibiotic-resistance increased by 9.3% rising from 18,740 cases in 2023 to 20,484 cases in 2024.

Figures also show the rate of resistant bacteraemia is 47% higher in the most deprived fifth of the population compared with the least deprived, a gap that has widened by 18% since 2019.

A national action plan for antimicrobial resistance was published in 2024 setting out the Government’s five-year strategy, including an ambition to cut total antimicrobial use in humans by 5% by 2029, compared to 2019.

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.’

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

Health minister Zubir Ahmed said: ‘These figures demonstrate the scale of the challenge we face and underline why tackling AMR is a key priority for this government.

‘It is deeply concerning that people in our most deprived communities are disproportionately affected by antibiotic-resistant infections.

‘We are determined to address these inequalities as part of our 10-Year Health Plan to ensure everyone, no matter where they live, gets the care they need.’

Professor Kamila Hawthorne, chair of the RCGP, said: ‘Antibiotic resistance remains one of the most serious global health threats we face, and GPs understand the dangers of infections becoming resistant to treatment. 

‘Over recent years, GPs have taken significant steps to reduce unnecessary antibiotic prescribing, ensuring that these medicines are used only when they are clinically appropriate.

‘But curbing antibiotic resistance is a shared responsibility – and it’s important that all prescribing clinicians working within the NHS and outside of it, as well as patients, play their role.’