24th November 2021

Following the publication of both the English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report 2020-2021 and its Scottish equivalent, Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2020, it might be tempting to celebrate the reported fall in the number of deaths in England attributable to antibiotic-resistance (AMR), as well as the overall decline in antibiotic consumption across England and Scotland. Yet we must remember that the ongoing COVID-19 pandemic will have, in all likelihood, distorted the picture.

While the number of bloodstream infections due to key pathogens has decreased, the proportion of these that are due to resistant organisms has increased. Additionally, while antimicrobial usage has decreased in primary care, there have been increases in antibiotic prescribing by dentists due to limited options for dental treatment during the pandemic. Prescribing in inpatient settings has increased in both England and Scotland with England also seeing increased use of WHO Watch and Reserve antibiotics, agents considered to have higher potential for resistance and last resort options for severe infections. Then there are additional factors to consider, such as greater public awareness on infection prevention, especially handwashing and mask-wearing, as well as a general decrease in socialising, which has reduced transmission of infections.

These factors make it difficult to draw any meaningful conclusions about the progress being made on appropriate antimicrobial use or the rise of resistance. Instead, we believe it is more useful to consider the upward trends in resistance reported up until the outbreak of the pandemic, and to double-down on our commitment to tackling it by optimising use of antimicrobials. This will require a broad One Health approach across all human and animal health settings as well as addressing AMR in the environment to support continued improvements in diagnostics, surveillance, and stewardship.

In other words, now is not the time to be complacent. With that in mind, the British Society for Antimicrobial Chemotherapy remains committed to tackling the silent pandemic of AMR, through our events and webinars, our open-access e-learning courses, our journals and much more. If you are not already a member, please do consider joining us. Membership is free – together we can help ensure a safer, healthier world for all.

Read the reports

ESPAUR report 2020 to 2021

Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2020


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