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Antimicrobial resistance increasing despite reduced GP antibiotic prescribing

Antimicrobial resistance ‘continues to increase’ despite a drop in the amount of antibiotics prescribed by GPs, a Government report has found.

The annual report, published by the Department of Health and Social Care, said that although there is increased public awareness and prescribing has decreased, antimicrobial resistance and the incidence of bloodstream infections have continued to rise.

It stressed that there is a need to ‘ensure that doctors always prescribe according to professional guidance’, but GP leaders have argued that the focus should be on the ‘abuse of antibiotics in agriculture’ rather than ‘scapegoating GPs’.

The Government has put a number of programmes in place since the Antimicrobial Resistance Strategy launched in 2013, including bids to reduce gram-negative bloodstream infections and inappropriate antibiotic prescribing in England by 50% by 2020/21.

But the 2016/17 report from the Advisory Committee on Antimicrobial Prescribing, Resistance and Healthcare Associated Infections found that resistance to antimicrobials, including antibiotics, antifungals and antivirals, has ‘continued to increase’.

It also highlighted that the incidence gram-negative bloodstream infections is still rising, meaning that ‘the burden of AMR as measured by the numbers of antibiotic-resistant infections continued to increase’.

The report concluded that there is an ‘ongoing clear need to educate the public about using antibiotics’ and to ‘ensure that doctors always prescribe according to professional guidance’.

The BMA’s GPC clinical and prescribing policy lead Dr Andrew Green said: ‘The rise in AMR, I’m afraid, is inevitable, as once the genes are in the environment there is no evolutionary pressure to lose them.

‘All we can do is to try to slow the rate of growth, and the fact that that is not zero does not mean we should stop trying.’

West Kent GP Dr Zishan Syed, a local representative for Kent LMC, said: ‘Analysis of the antibiotic crisis should surely focus on the abuse of antibiotics in agriculture rather than scapegoating GPs.

‘GPs are being asked to combat sepsis which will require the use of antibiotics and are being asked to be more sepsis aware and yet they are being told in other guidelines to reduce antibiotic use. This is frankly impossible.’

A Department of Health and Social Care spokesperson said: ‘We are making good progress. In recent years antibiotics prescriptions by GPs decreased by 13% and sales of antibiotics for use in food-producing animals dropped by 27%, meeting one of the Government commitments to Lord O’Neill’s Review’s recommendations two years early.’ 

The findings come after the DHSC’s Chief Medical Officer sent out individual letters to 9,000 GPs telling them that they are overprescribing antibiotics.