Antibiotic use within the NHS is below 2019 pre-pandemic levels but private prescribing increases.
National surveillance data published by the UK Health Security Agency (UKHSA) show that the total number of antibiotic-resistant infections in 2024 equates to an average of nearly 400 newly reported cases per week.
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.
The estimated number of deaths in people with a 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 of Antibiotic Prescribing and Utilisation Report (ESPAUR) 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.
The report offers vital insights into the scale of the problem we face as the UK urgently tackles antibiotic resistance through 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.
Antibiotic resistance occurs naturally but there are ways that it can be tackled, including by limiting antibiotic use to where it's most needed.
Between 2019 and 2024, NHS primary care antibiotic use decreased (from 14.21 to 13.96 DID), while private dispensing in community pharmacies more than doubled (1.95 to 3.93 DID). Overall, primary care antibiotic use (NHS and private non-NHS) rose by 10.7% between 2019 and 2024, reflecting a large rise in private prescriptions, with 22% of antibiotics in 2024 dispensed through the private sector.
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.
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.
Health Minister Zubir Ahmed said:
Antimicrobial resistance (AMR) is one of the most serious threats to public health, both in the UK and globally. 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.
We will continue working closely with UKHSA, the NHS and international partners to tackle this growing threat. Everyone has a role to play - by using antibiotics responsibly, taking up vaccinations, and following the advice of clinicians, we can all help preserve these vital medicines for future generations.
Professor Matt Inada-Kim, National Clinical Director for Infection, Antimicrobial Resistance and Deterioration at NHS England, said:
Resistance to antibiotics is a growing problem and tackling it means looking at the full picture - from infection prevention and awareness about the proper use of antibiotics to same-day care, as well as rapid testing to help doctors give antibiotics only to those who really need them.
We're also working with NICE to support the development of new antibiotics through a world-first, fair, innovative funding model to make sure we have what we need to tackle the rising threat of drug-resistant infections now and in the future.
Dr Nicola Rose, Interim Executive Director of Science and Research at the MHRA, said:
These figures underline the growing impact of antibiotic-resistant infections, and why action across science, regulation and healthcare is vital. At the MHRA, we are working closely with partners across the health system to support efforts to slow the spread of resistance and help bring new treatments to patients more quickly. This includes supporting the development of safe, new antibiotics, vaccines and diagnostics. Further, we are enabling promising areas of research and development - such as microbiome therapies and bacteriophage treatments - to progress safely, supported by clear guidance and our biological reference materials.
With resistance increasing and patterns of antibiotic use changing, it's more important than ever to strengthen how we detect and track emerging threats. Together with the UKHSA, we are using real world data from hospitals, GPs, pharmacies and the environment to spot new risks early and act on them quickly. We are also collaborating with regulators worldwide to support safe and timely access to new treatments.
Tackling antibiotic resistance will take sustained effort, but by combining vigilance with innovation and working closely with partners globally, we can help keep these life-saving medicines effective for everyone who needs them.
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.
UKHSA continues to work with partners to understand the reasons for these differences and design interventions to tackle them.
