Antibiotics can be used to treat, or prevent infections, caused by bacteria in humans and animals. Antibiotics do not work against viruses. The widespread use and availability of antibiotics has and continues to save lives. On the down side, overuse of antibiotics has meant some bacteria are now resistant to them. This is referred to as Antimicrobial Resistance, often abbreviated to AMR. A similar problem exists with other antimicrobial drugs including antivirals and antifungals.
Antimicrobial resistance is a serious issue in the UK and across the world. The World Health Organisation (WHO) has declared it one of the top 10 global public health threats.
UK Antibiotic facts
In the UK an estimated 20% of all antibiotic prescriptions are inappropriate in primary care. One in three patients in hospitals in England are on antibiotics at any one time. And, one in three people take at least one course of antibiotics in England each year. The UK is one of the biggest users of antibiotics in Europe, using twice as many as the lowest European user.
In UK Primary Care, 60% of antibiotic prescriptions are given for respiratory tract infections, the majority of which are caused by viruses. In most cases in otherwise healthy adults such infections are self limiting and can be manged by self care including Pelargonium.
Since 2000 the UK Government has had strategies and action plans in place to address antimicrobial resistance. Five year antimicrobial resistance strategies have been in place. During the 2013 - 2018 strategy human antibiotic use reduced by 7.3% and there was a 40% reduction in sales of veterinary antibiotics in the UK.
In 2019 the UK Government published a 20-year vision on antimicrobial resistance. It outlines nine ambitions for change. Recognising that controlling antimicrobial resistance requires an international effort, continuing to be a global partner is the first ambition. Other ambitions in the plan include driving innovation, minimising infection and environmental spread, demonstrating the appropriate use of antimicrobial products. Ambition 9 is perhaps the most important, engaging the public on antimicrobial resistance to take ownership of the issues and solutions.
Public Health England launched a Keep Antibiotics Working campaign in 2017 to support the Government's programmes of reducing resistance and inappropriate antibiotic use. Both patients and healthcare professionals are encouraged to become Antibiotic Guardians.
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Not just antibiotics
A review of all prescribing in England was commissioned by the Secretary of State for Health and Social Care in 2018. The review was lead by the then Chief Pharmaceutical Officer for England, Dr Keith Ridge CBE. The review estimated that at least 10% of medicines may be over prescribed. In 2020 there were over 1 billion prescription items dispensed in England. The average number of prescription items per head of population doubled from 10 to 20 between 1996 and 2016. The reasons are complex and include factors related to clinicians, patients and the health system itself.