{"id":48539,"date":"2014-10-09T23:15:02","date_gmt":"2014-10-09T23:15:02","guid":{"rendered":"http:\/\/mostafa.openonline.co.uk\/?guid=0393d8ae74e99653e776576faac52df3"},"modified":"2014-10-09T23:15:02","modified_gmt":"2014-10-09T23:15:02","slug":"press-release-new-report-reveals-increase-in-use-of-antibiotics-linked-to-rising-levels-of-antibiotic-resistance","status":"publish","type":"post","link":"https:\/\/mostafa.openonline.co.uk\/?p=48539","title":{"rendered":"Press release: New report reveals increase in use of antibiotics linked to rising levels of antibiotic resistance"},"content":{"rendered":"<div class=\"govspeak\">\n<p>A new report from Public Health England (<abbr title=\"Public Health England\">PHE<\/abbr>) found that between 2010 and 2013 there was a 6% increase in the combined antibiotic prescribing of <abbr title=\"General practitioners (family doctors)\">GPs<\/abbr> and hospitals. There was also an increase of 12% in the number of bloodstream infections caused by E.coli with varying levels of resistance to key antibiotics for this infection of between 10 to 19%.<\/p>\n<p>These data are from the first annual report of <abbr title=\"Public Health England\">PHE<\/abbr>\u2019s English Surveillance Programme for Antimicrobial Utilisation and Resistance (<abbr title=\"English Surveillance Programme for Antimicrobial Utilisation and Resistance\">ESPAUR<\/abbr>), published today (10 October 2014).<\/p>\n<p>While the proportion of resistant infections remains the same as that seen in previous years, as the total number of infections has increased so the total number of resistant infections has risen. The report also shows a wide variation in both prescribing habits and antibiotic usage across England.<\/p>\n<p>Key findings:<\/p>\n<ul>\n<li>between 2010 and 2013 total antibiotic consumption (<abbr title=\"General practitioners (family doctors)\">GPs<\/abbr> and hospitals) rose by 6% from 25.9 to 27.4 daily defined dose* per 1,000 inhabitants per day<\/li>\n<li>over the same 4-year period <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> prescribing rose by 4%, prescribing to hospital inpatients rose by 12% and other community prescriptions (dentists and other non-<abbr title=\"General practitioner (family doctor)\">GP<\/abbr> prescribing) rose by 32%. This latter area is of concern and needs to be further examined  <\/li>\n<li>the increasing number of E.coli bloodstream infections has seen a corresponding increase in levels of resistance to a number of key antibiotics  <\/li>\n<li>higher rates of resistance were seen in those areas with higher rates of prescribing<\/li>\n<li>there was a difference in prescribing between the north and south of the country. This is an area that needs more investigation but some of the differences may be due to deprivation, higher rates of smoking, co-morbidities, and other factors<\/li>\n<li>the highest levels of <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> prescribing were seen in Durham, Darlington and Tees which was over 40% higher than London (26.5 versus 18.9 daily defined dose per 1,000 inhabitants). However, this may be due to access to healthcare in London (with people attending hospitals instead of <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> practices to access treatment), as London has the highest amount of hospital prescribing per population <\/li>\n<\/ul>\n<p>Lead author Dr Susan Hopkins, a healthcare epidemiologist at <abbr title=\"Public Health England\">PHE<\/abbr>, said: <\/p>\n<blockquote>\n<p>This publication marks a real move forward in our understanding of antibiotic prescribing habits as it is the first time that both <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> and hospital prescribing data have been collated in one document and prescribing trends analysed.<\/p>\n<p>The aim now must be to reduce levels of prescribing back to that seen in 2010. There are already a number of different activities going ahead to support this including the development of quality measures for prescribing. This will enable local clinical commissioning groups to monitor the prescribing of hospitals and surgeries in their area and see how they compare against a benchmark. They will also be responsible for taking action against inappropriate prescribing in their area.<\/p>\n<p class=\"last-child\">In addressing the issue of antibiotic resistance it is important to look at the whole healthcare economy approach. There is a lot of work going on to address the problem of antibiotic resistance but we must not underestimate how much work needs to be done to turn the tide and get levels of resistance down.<\/p>\n<\/blockquote>\n<p>Professor John Watson, deputy chief medical officer at the Department of Health, said:<\/p>\n<blockquote>\n<p class=\"last-child\">Antimicrobial resistance is one of the biggest threats to health security facing the world today and everybody must take action. We want to support all doctors and other prescribers in reducing their prescribing rates where possible.  These data will play an important part in highlighting regional variations in prescribing.<\/p>\n<\/blockquote>\n<p>Professor Anthony Kessel, director of international public health at <abbr title=\"Public Health England\">PHE<\/abbr>, said: <\/p>\n<blockquote>\n<p>We cannot underestimate the importance of this report. Antibiotic resistance is one of the biggest threats of our time and understanding more about who is prescribing and what is being prescribed is the first step to helping us make improvements.<\/p>\n<p>In England we are progressing and implementing a raft of tools to help us reduce the levels of prescribing and resistance and these include benchmarking, accountability on prescribing and quality measures. We are also asking everyone in the UK, the public and the medical community, to join our campaign and become an Antibiotic Guardian. We want everyone to choose one simple pledge about how they make better use of antibiotics and help save these vital medicines from becoming obsolete.<\/p>\n<p class=\"last-child\"><abbr title=\"English Surveillance Programme for Antimicrobial Utilisation and Resistance\">ESPAUR<\/abbr> was established as a response to the UK cross government 5-year strategy to address the growing problem of antibiotic resistance. The report focuses on the use of antibiotics, stewardship and levels of resistance by NHS area team across <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> practices and hospitals (primary and secondary care).<\/p>\n<\/blockquote>\n<h3 id=\"ends\">Ends<\/h3>\n<h2 id=\"notes-to-editors\">Notes to editors<\/h2>\n<ul>\n<li>\n<a href=\"https:\/\/www.gov.uk\/government\/publications\/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report\">Read the <abbr title=\"Public Health England\">PHE<\/abbr> English surveillance programme antimicrobial utilisation and resistance report<\/a>.<\/li>\n<li>Both the primary and secondary care data is expressed as a defined daily dose (<abbr title=\"Defined Daily Dose\">DDD<\/abbr>) which is an internationally recognised unit of measurement of medicine consumption recommended by the WHO. <\/li>\n<li>The highest combined <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> and hospital prescribing was in Merseyside (30.4 <abbr title=\"Defined Daily Dose\">DDD<\/abbr> per 1,000 inhabitants). Although rates of prescribing were higher in this area there were more narrow-spectrum antibiotics prescribed which are the preferred choices, wherever possible. <\/li>\n<li>The area with the lowest combined prescribing was in the Thames Valley with 22.8 <abbr title=\"Defined Daily Dose\">DDD<\/abbr> per 1,000 inhabitants per day).<\/li>\n<li>Consumption rates at a national and Area Team level were calculated using 2010 to 2011 and 2012 mid-year resident population estimates based on the 2011 census for England. 2013 consumption rates are based on 2012 mid-year population estimates.<\/li>\n<li>From 2010 to 2013 hospital admissions rose by 2.4% and bed-days declined by 1.3%. This suggests that there was increased activity but earlier discharge from hospital. <\/li>\n<li>\n<abbr title=\"General practitioner (family doctor)\">GP<\/abbr> prescribing rose by 4.1% between 2010 and 2013 from 20.6 to 21.5 <abbr title=\"Defined Daily Dose\">DDD<\/abbr> per 1,000 inhabitants each day. Prescribing to hospital inpatients rose by 12% from 2.3 to 2.5 <abbr title=\"Defined Daily Dose\">DDD<\/abbr> per 1,000 inhabitants per day over the same period and community prescribing rose by 32% from 1.3 to 1.7 <abbr title=\"Defined Daily Dose\">DDD<\/abbr> per 1,000 inhabitants per day.<\/li>\n<li>Between 2010 and 2013 the predominant antibiotics in use in England were penicillins, tetracyclines and macrolides. <\/li>\n<li>In terms of the totality of prescribing in 2013, 66 different antibiotics were prescribed with the top 15 agents accounting for 98% and 88% of <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> and hospital consumption respectively. <\/li>\n<li>E.coli  &#8211; between 2010 and 2013 resistance to an antibiotic called ciprofloxacin increased 18% (3,654 to 4,321) and resistance to cephalosporins and gentamicin rose 28 and 27% respectively. <\/li>\n<li>Use of tetracyclines has risen significantly between 2010 and 2013 in both <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> practices and in hospitals in all Area Teams. The <abbr title=\"Defined Daily Dose\">DDD<\/abbr> has risen from 3.9 to 4.5 per 1,000 inhabitants per day in <abbr title=\"General practitioner (family doctor)\">GP<\/abbr> practices and hospitals from 0.18 to 0.21 per 1,000 inhabitants per day.<\/li>\n<li>You can make your pledges on the <a rel=\"external\" href=\"http:\/\/antibioticguardian.com\/\">Antibiotic Guardian website<\/a> <\/li>\n<li>Public Health England\u2019s mission is to protect and improve the nation\u2019s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. <abbr title=\"Public Health England\">PHE<\/abbr> is an operationally autonomous executive agency of the Department of Health.    <\/li>\n<\/ul>\n<div class=\"contact postal-address\" id=\"contact_1107\">\n<div class=\"content\">\n<h3>Infections press office<\/h3>\n<div class=\"vcard contact-inner\">\n<p class=\"adr\">\n<span class=\"fn\"><abbr title=\"Public Health England\">PHE<\/abbr> press office &#8211; infections<\/span><br \/><span class=\"street-address\">61 Colindale Avenue<\/span><br \/><span class=\"locality\">London<\/span><br \/><span class=\"postal-code\">NW9 5EQ<\/span>\n<\/p>\n<div class=\"email-url-number\">\n<p class=\"email\">\n              <span class=\"type\">Email<\/span><br \/>\n              <a class=\"email\" href=\"mailto:infections-pressoffice@phe.gov.uk\">infections-pressoffice@phe.gov.uk<\/a>\n            <\/p>\n<p class=\"tel\">\n              <span class=\"type\">Phone<\/span><br \/>\n              020 8327 7901\n            <\/p>\n<p class=\"tel\">\n              <span class=\"type\">Out of hours<\/span><br \/>\n              020 8200 4400\n            <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Combined GP and hospital prescribing up 6% between 2010 and 2013. Levels of antibiotic resistance also up.<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"_links":{"self":[{"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/48539"}],"collection":[{"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=48539"}],"version-history":[{"count":0,"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/48539\/revisions"}],"wp:attachment":[{"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=48539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=48539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mostafa.openonline.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=48539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}