NHS warning of ‘overuse’ risk, as new report warns of antibiotic resistance

As new data shows the North East has the highest rate of blood poisoning and highest levels of antibiotic use, a leading regional medic has warned over-use of antibiotics could make things “far worse”.

An annual report from the UK Health Security Agency has highlighted how our region has the highest prevalence of blood stream infections – such as septicaemia – in the country when adjusted for population. However, in more positive news the region also has the lowest “burden” of antibiotic resistance in those infections.

This is despite the fact that we see the most antibiotics prescribed per head. Dr Neil O’Brien, executive medical director at the North East and North Cumbria NHS Integrated Care Board said many of the reasons for the high levels of both infection and prescribing were “like the weather – things we can’t change”.

But he also spoke of his own commitment to reducing prescribing where possible – and called for the public to help by following key antibiotic rules, including only ever taking them when told to by a health professional. This comes on the back of what the UKHSA has called “concerning rises” in cases of people dying of infections resistant to antibiotics over the past year.

The chief executive of the UKHSA, Dame Jenny Harries, urged people in England to “treat antibiotics with respect” to ensure they are effective in the future. According to the UKHSA, 58,224 people in England had an antibiotic-resistant infection in 2022, up 4% on 2021. Some 2,202 people died as a result, up from 2,110 in the previous 12 months.

In the report, released last week, the agency highlights that declines in antibiotic use between 2014 and 2020 had reversed – with an increase in 2022 of 8.4%, though that remains below pre-pandemic levels.

The agency also explained that the proportion of antibiotic resistant blood stream infections (one in five) had been stable since 2018. But with some specific pathogens such as Klebsiella pneuomniae – which can cause sepsis – there is evidence of increasing resistance to antibiotics.

The formal report examining the issue across 2022 highlights how: “Whilst the North East had the highest incidence rate of selected BSI pathogens (183.8 per 100,000 population), the resistance rate (25 to 30 per 100,000 population) was lower than that seen in many other regions.”

The rate of dispensing of antibiotics had also “consistently been greatest within the North East and North West of England, and lowest in London”.

Dr Neil O’Brien, executive medical director at North East and North Cumbria Integrated Care Board, said the issue was a concerning one, but highlighted how the data highlighted in the report is intimately connected with the health inequality faced in the North East – especially as issues such as smoking levels and social deprivation had links to higher levels of antibiotic use.

However he also pointed to the data and said that while the figures are high in our region, they have been stable over 2022, when compared to national increases. Dr O’Brien said: “Antibiotics are essential for treating serious infections, but if bacteria become resistant to them, we’re all at higher risk of things like bloodstream infections, sepsis and severe illness.

“Some resistance happens naturally, but if we overuse antibiotics, we make it far worse. The stark reality is that three million operations a year could become life-threatening if antibiotics stop working effectively. There are many reasons for our region’s high rates of bloodstream infections and antibiotic prescribing. Some of these – like the weather – are things we can’t change.

“Smoking, deprivation, and chronic diseases among people who worked in heavy industry, are all factors – and these are all priorities for the region’s NHS. We’ve set ambitious targets for reducing smoking, tackling inequalities in health and improving the way we manage long-term conditions. We are working with hospitals, pharmacies and GP practices to reduce prescribing where possible, as well as running a campaign to help people understand just how important this is.

“But we need your help too. Only take antibiotics if you are told to do so by a health professional. And remember, antibiotics don’t work for viruses like colds, flu or Covid-19. Never save them for later and never share them with others. Simple steps also make a difference – stay away from vulnerable people if you are unwell, wash your hands regularly and keep rooms ventilated.”

Dr O’Brien said he himself had pledged to be an “antibiotic guardian” and that this was a way professionals could help to ensure public awareness of the importance of only using antibiotics where needed.