Why don’t we just…
reduce antibiotic use?

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World Antimicrobial Awareness Week 2021 (WAAW21), which runs from 18-24 November, calls on policymakers, healthcare providers and the general public to “spread awareness, stop resistance” to the prescribing and use of antibiotics.

To coincide with WAAW21, the UK Health Security Agency has released the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR), which includes national surveillance data on antimicrobial prescribing, resistance and stewardship.

The report shows that, while antibiotic prescribing reduced significantly in 2020, this was likely due to the impact of Covid-19 restrictions.

Infection prevention control measures such as social distancing, enhanced hand hygiene and remote consultations led to reduced incidence of serious bacterial infections and played a part in driving down antibiotic resistance and prescribing.

However, the proportion of bloodstream infections that were resistant to one or more antibiotics increased, suggesting we are likely to see a rise in antibiotic-resistant infections as pandemic-related restrictions are discontinued.

Antimicrobial resistance (AMR) has been described as a hidden pandemic and it’s important that we do not come out of Covid-19 and enter into another crisis. We need to take action now to avoid unnecessary use.

Antibiotics are vital for the treatment of bacterial infections causing pneumonia, meningitis and sepsis. Without them, modern medical technology could not exist, as they also help to protect against infection during chemotherapy, caesarean sections and other common surgeries.

But they are sometimes prescribed to treat minor illnesses, such as coughs, earache and sore throats where it is now clear they may have little or no effect.

Antibiotic resistance occurs when bacteria no longer respond to treatment, causing serious complications, including bloodstream infections and hospitalisation. Taking antibiotics encourages harmful bacteria that live inside you to become resistant.

That means that antibiotics may not work when you really need them. So it is important to take antibiotics only when they are needed and helpful.

At UKHSA, we recommend that healthcare professionals explain to patients that antibiotics do not prevent or treat viral infections including Covid-19 and they can actually cause side-effects, including nausea and diarrhoea.

Antibiotic use can also increase the risk of spreading infections that are caused by bacteria resistant to antibiotics.

Health professionals are being urged to treat coughs, fever and breathlessness related to Covid-19 in line with clinical guidance, not with antibiotics, and to follow current NICE guidelines to determine if pneumonia has a Covid-19, viral or bacterial cause.

As we head into winter and see a rise in respiratory tract infections, it’s important to remember that antibiotics are not needed for many cold-like symptoms.

The best advice is to stay at home if you feel unwell. Taking antibiotics when you don’t need them only puts you and your loved ones at more risk in the future so please listen to your GP, nurse, dentist or pharmacist’s advice.

Dr Will Morton is health protection consultant at UK Health Security Agency North West

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