UK five year antimicrobial resistance strategy 2013-2018: annual progress report, 2016

DH's third annual progress report on the UK's antimicrobial resistance strategy describes the activities and achievements over 2016.

It notes that for the remaining two years of the strategy, the programme will focus on the delivery of the government's ambitions to halve certain types of infections and the inappropriate use of antibiotics.

See also Call to Action on Antimicrobial Resistance (AMR). a summary of roundtable on antimicrobial resistance. This report summarises the discussions that took place and the resulting underpinning principles for action as agreed by the co-hosts.

Health matters: preventing infections and reducing AMR

Guidance from Public Health England outlining the importance of infection prevention and control and how it can contribute to reducing antimicrobial resistance (AMR).

English Surveillance Programme for Antimicrobial Utilisation and Resistance’ (ESPAUR)

The 'English Surveillance Programme for Antimicrobial Utilisation and Resistance’ (ESPAUR) report says more than one million UTI samples were analysed in NHS laboratories across England last year (2016), and that resistance was a “common” observation.

One in three (34%) of the samples analysed were found to be resistant to an antibiotic called trimethoprim, compared to 29.1% in 2015.

Public Health England has also launched a major new campaign to help ‘Keep Antibiotics Working’.

The campaign warns people that taking antibiotics when they are not needed puts them at risk of a more severe or longer infection, and urges people to take their doctor’s advice on antibiotics.

The pharmacy contribution to antimicrobial stewardship

This report from the Royal Pharmaceutical Society focuses on the pharmacist’s role as part of a multidisciplinary approach in tackling the challenges of inappropriate use of antibiotics.

The recommendations in this policy have been produced in order to contribute to wider efforts in meeting the challenge set by the UK Government in 2016 of reducing inappropriate antibiotic prescribing by 50 per cent by 2020.

Questions over advice to finish courses of antibiotics

"Should you finish a course of antibiotics?" asks BBC Online. The question is prompted by a new review suggesting concerns around antibiotic treatment are driven by fears of under-treatment, when we should instead be concerned about over-use.

This narrative review was written by researchers from several UK institutions, including Brighton and Sussex Medical School, the University of Oxford and the University of Southampton. It was published in the peer-reviewed British Medical Journal.

Generally the UK media's coverage was accurate and balanced. The majority of reporting referred to the review as an "opinion piece" and highlighted the importance of people continuing to follow doctors' advice to complete a prescribed antibiotic course.

New NICE advice about when to give antibiotics for common infections

For the first time NICE is giving specific advice for doctors and nurses about when and how to prescribe antibiotics for conditions such as sore throats and colds.

The new series of 30 guidelines will help frontline healthcare workers in the battle against antimicrobial resistance (AMR) by preventing unnecessary use of the drugs.

Draft guidance on sinusitis (commonly known as a ‘stuffy nose’) and acute sore throats has been published with final recommendations for sinusitis due in August 2017.

WHO issues warning about rise of drug-resistant gonorrhoea

"Gonorrhoea fast becoming 'untreatable', WHO experts warn," reports Sky News.

Analysis of data from 77 countries by the World Health Organization (WHO) found antibiotic resistance exists against almost all antibiotics currently used to treat the sexually transmitted infection (STI) gonorrhoea.

In this study, a WHO group outlined a new strategy to support the research and development of new treatments for gonorrhoea. Preventing the spread of the STI is also of paramount importance.

Combatting antimicrobial resistance Educational approaches for the responsible prescribing of antimicrobials

This report presents the results of survey of higher education institutions about the extent to which antimicrobial prescribing and stewardship competencies have been embedded into their curricula. It also sets out recommendations for HEE, employers and healthcare providers to ensure that staff are well-trained in how to combat antimicrobial resistance.

Antimicrobial Resistance: resource handbook

This handbook from Public Health England collates national resources on antimicrobial resistance, antimicrobial stewardship and infection prevention and control.

Resources to support delivery of ‘Reducing the impact of serious infection’ CQUIN

NHS Improvement and Public Health England have developed resources to support providers and commissioners in the delivery of the national ‘Reducing the impact of serious infections (Antimicrobial Resistance and Sepsis)’ CQUIN.

The resources include a series of FAQs, tools for data collections and baseline data, and are available via the NHS Improvement website or on the CQUIN webpage.

Antimicrobial stewardship: changing risk-related behaviours in the general population

New NICE guidance on making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includes measures to prevent and control infection that can stop people needing antimicrobials or spreading infection to others. It aims to change people’s behaviour to reduce antimicrobial resistance and the spread of resistant microbes.

Last-line antibiotics are failing: options to address this urgent threat to patients and healthcare systems

This ECDC briefing aims to draw the attention of policymakers to examples of measures that can be taken at national and local levels to halt the spread of highly resistant bacteria. Case studies illustrating successful implementation of such measures, are also highlighted.

Superbugs: real problem, real work

An enterprising team at Attenborough Surgery in Bushey, Hertfordshire took the evidence and NICE recommendation and launched a pilot project to reduce antibiotic prescribing for people with respiratory infections. Patients were offered the CRP test and those not prescribed antibiotics, or offered a delayed prescription, were given written self-care advice. The results were impressive.

• 70% of patients presenting with a suspected lower respiratory tract infection had low levels of C-Reactive Protein (CRP <20mg/L)
• Prescription of antibiotics was reduced by 23% (8% of patients were prescribed antibiotics on their first visit during the winter that CRP testing was introduced, compared with 31% the previous winter)
• Unscheduled follow-up visits within 28 days for patients who were not prescribed antibiotics fell by more than 50%

English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report

The ESPAUR report includes national data on antibiotic prescribing and resistance, and hospital antimicrobial stewardship implementation.

Antimicrobial resistance

Antimicrobial Resistance Empirical and Statistical Evidence-Base
Provides an overview of the current situation of antimicrobial resistance in bacteria, viruses and fungi that can cause disease in humans.

Progress report on the UK 5 year AMR strategy: 2015

The second annual progress report on the UK 5 year antimicrobial resistance (AMR) strategy including future plans.

What If Antibiotics Were To Stop Working?

The NHS if is a collection of essays that explores hypothetical scenarios and their impact on the future of health and care. 

The aim is to encourage new thinking and debate about possible future scenarios that could fundamentally change health and care. This essay, by Professor Dame Sally Davies and Rebecca Sugden, explores a future in which antimicrobial resistance changes the face of medicine and health care.

Clinical implications, impact on longevity and the potential economic cost of current trends in AMR

This Longevity Bulletin examines the clinical implications, impact on longevity and the potential economic cost of current trends in AMR.

Antibiotics are one of the most important therapeutic discoveries in medical history. They have revolutionised the way we treat patients with bacterial infections and have contributed to reducing mortality and morbidity from bacterial diseases.
Unfortunately, antibiotics have been liable to misuse. They are often unnecessarily prescribed for viral infections, against which they have no effect.

In the Longevity Bulletin, Professor Dame Sally Davies, Chief Medical Officer for England, states that the world is already seeing the consequence of AMR with estimates of around 50,000 deaths per year recently in Europe and the US. Furthermore, drug-resistant infections are estimated to cause 10 million deaths a year and cost up to £66 trillion by 2050.

Anti-Microbial Resistance (AMR) CQUIN

To support the delivery of the national AMR CQUIN, NHS England (NHSE) has been working with NHS Improvement (NHSI) and Public Health England (PHE) to develop FAQs and data collection forms.