New data by the UK Health Security Agency (UKHSA) shows that antibiotic-resistant bloodstream infections fell in 2020, from 65,583 in 2019 to 55,384. However, it remains at a higher level than six years ago.
Antibiotics are essential for treating bacterial infections such as pneumonia, meningitis, and sepsis. They work by killing bacteria or preventing it from spreading, and they help protect against infection during chemotherapy, caesarean sections, and other common surgeries. However, they have been prescribed to treat common coughs, earache, and sore throats in the past, but it is now clear that they may have little or no effect.
The decline seen in 2020 could be possibly driven by a reduction in recorded bloodstream infections due to less social mixing, enhanced hand hygiene and changes to healthcare access and delivery.
The rise of overusing antibiotics
Antibiotic resistance occurs when bacteria no longer respond to treatment which causes serious complications such as bloodstream infections and hospitalisation. The sudden emergence of “superbugs” means that strains of bacteria have developed a resistance to many types of antibiotics including, MRSA (methicillin-resistant Staphylococcus aureus), Clostridium difficile (C. diff) and the bacteria that cause multi-drug-resistant tuberculosis. As a result, these infections are challenging to treat with disability and death becoming more prevalent.
Antibiotics were previously prescribed sometimes to treat infections in the ears and chests of children and for sore throats; however, it is now clear that antibiotics are not effective, are unlikely to speed up the healing process, and cause unwanted side effects.
Analysis of the bacteria that most commonly cause bloodstream infections, including E. coli, revealed that although the overall number of bloodstream infections decreased in 2020 compared to 2016, the overall proportion of infections that were resistant to antibiotics increased over the same time frame. This is likely to be a result of changing behaviours, prescriptions, and healthcare delivery in 2020 – 1 in 5 people with bloodstream infections in 2020 had an antibiotic-resistant infection. This suggests that resistant infections are likely to rise in post-pandemic years and will require ongoing actions.
Reducing usage
Efforts to decrease the prescription of antibiotics has been encouraged, and with antibiotic prescriptions reducing further during the pandemic, from 18 Defined Daily Doses (DDDs) per 1,000 inhabitants in 2019 to 16 DDDs per 1,000 inhabitants in 2020 – this could be driven by reductions in antibiotics usually prescribed for respiratory infections. However, antibiotics in dentistry had increased in 2020 for the first time in years, highlighting the importance of face-to-face dentist practice.
Dr Susan Hopkins, Chief Medical Advisor at UKHSA, said: “Antimicrobial resistance (AMR) has been described as a hidden pandemic, and it’s important that we do not come out of COVID-19 and enter into another crisis.”
“It is likely that COVID-19 restrictions in 2020 including enhanced infection, prevention and control measures also played a part in driving down antibiotic resistance and prescribing. While these measures were severe, serious antibiotic-resistant infections will rise once again if we don’t act responsibly, and that can be as simple as regular and thorough handwashing.”
“As we head into winter, with increasing amounts of respiratory infections in circulation, it’s important to remember that antibiotics are not needed for many cold-like symptoms. Stay at home if you feel unwell. Taking antibiotics when you don’t need them only puts you and your loved ones at more risk in the future, so please listen to your GP, nurse, dentist or pharmacist’s advice.”
