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There were an estimated 66,730 serious antibiotic-resistant infections in 2023.

National surveillance data published by the UK Health Security Agency show that antibiotic resistant infections in 2023 surpassed pre-pandemic levels. There were an estimated 66,730 serious antibiotic resistant infections in 2023, compared to 62,314 in 2019.

The English Surveillance of Antibiotic Prescribing and Utilisation Report (ESPAUR) shows that the majority of antibiotic resistant bloodstream infections in the last 5 years (65%) were caused by E. coli – a common cause of urinary tract infections, diarrhoea, vomiting and fever.

Antibiotic resistant bacteria of any kind are less likely to respond to treatment, causing serious complications, including bloodstream infections, 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 sensitive infection.

Antibiotic resistance occurs naturally but managing antibiotic consumption and only using them when appropriate is essential to limiting the emergence of antibiotic resistant bacteria and associated deaths related to these infections.

Data for 2023 also highlight 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 more deprived communities were 42.6% more likely to have an antibiotic resistant infection, compared to those in the least deprived areas. This is higher than in 2019 (29.4%). Overall, from 2019 to 2023, rates of resistant infections in the most deprived populations of England have increased by 9.5% in 2023.

Most antibiotic resistant infections are in white ethnic groups (89.8%), while Asian or Asian British ethnic groups have the highest proportion of antibiotic resistant infections (39.4%). UKHSA is working with partners to understand the reasons for these differences and design interventions to tackle them.

Professor Dame Jenny Harries, Chief Executive of UKHSA, said:

Increasingly the first antibiotics that patients receive aren’t effective at tackling their infections. That’s not just an inconvenience – it means they are at greater risk of developing a severe infection and sepsis. Our declining ability to treat and prevent infections is having an increasing impact, particularly on our poorest communities.

While we work with partners to innovate new approaches and life-saving treatments, there are steps everyone can take. Take up the vaccinations you are eligible for to help stop infections in the first place. 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.

This isn’t just for your own health - it’s about protecting everyone in our communities and future generations.

Antibiotic use also rose in 2023 by 2.4%, compared to 2022, and prescribing levels are now in line with those seen in 2019. The increases were across the majority of antibiotic groups, with penicillins accounting for the most frequently prescribed antibiotic group in primary and secondary care.

This latest data provide important insight into the scale of the problem we are facing and will help guide the goals set out in the new UK AMR National Action Plan 2024-2029 earlier this year. This includes ambitions to reduce total antibiotic use in human populations by 5% from the 2019 baseline and investments in new tools and technologies to develop long-lasting solutions.

Minister for Public Health and Prevention, Andrew Gwynne, said:

“This report lays bare the devastating impact of antimicrobial resistance (AMR) in the UK and around the world. > > This is an urgent global threat and one we are tackling through our ambitious AMR national action plan. It is clear this emergency cannot be tackled by one nation alone - that is why we are working tirelessly with partners to implement the commitments made by global leaders on AMR at this year’s United Nations General Assembly. 

Patient and campaigner, Caroline Sampson, explains how an antibiotic resistant infection has impacted her life:

For 8 and a half years, I have had a chronic urinary tract infection (UTI). No form of antibiotics has successfully treated it. It has derailed my life in every possible way. 

I can no longer enjoy simple pleasures like eating out, going to the theatre or inviting friends over. The daily symptoms are debilitating and painful. Trying to accomplish the smallest task takes a huge amount of effort. The impact on my mental health has been enormous and I live with daily anxiety that the infection could develop into urosepsis. 

I just want my life back. The threat of antibiotic resistant infections to us all cannot be underestimated.

The UKHSA is working with the Medicines and Healthcare products Regulatory Agency (MHRA) on innovative ways to combat antibiotic resistance by developing quality standards to support the research and development of novel therapeutics and treatments to tackle antibiotic resistance in the UK and around the world.

Dr Nicola Rose, Interim Executive Director, Science and Research of MHRA, said:

Our purpose is to improve patient safety. Our scientists are working with UKHSA to support interventions to tackle antibiotic resistance, including close collaboration with the emerging microbiome research community, bacteriophage innovators, novel diagnostics developers, and those developing new bacterial vaccines.

In the fight against antibiotic resistance it is of utmost importance to enable the development and timely access to novel therapeutics, such as microbiome interventions and phage therapy, something we have been focusing on the recent years.

We are also exploring improved detection and surveillance of antimicrobial resistance genes through biological standardisation so we can quickly identify potential threats and resistant germs in hospitals and the environment.