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Reducing primary care antibiotic use may not be enough to counter antimicrobial resistance

Reducing antibiotic prescribing did not halt drug resistant E. coli infections, study found

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A new report led by researchers at Imperial College London has found that reducing antibiotic prescribing in primary care alone may not be enough to halt the rise in drug resistant Escherichia coli (E. coli) infections in England.

The report on antimicrobial resistance (AMR) has been published in The Lancet Infectious Diseases. It is the first evaluation of NHS England’s Quality Premium scheme, which rewarded groups of general practitioners (GPs) for quality of care improvements, which included the reduction of inappropriate antibiotic prescribing.

The Global Digital Health unit team at Imperial College London linked data from 6,882 English general practices with Public Health England’s (PHE) national surveillance of bacterial infections over the six-year period from January 2013 to December 2018 when the NHS Quality Premium was in operation.

The report found that although the intervention saw a downward step change in antibiotic prescribing, this only led to a modest reduction in antibiotic resistant infections from E. coli.

A more radical, multi-sectoral approach is needed to tackle the growing threat of AMR, the study’s authors concluded.

Céire Costelloe, reader and director of the Global Digital Health Unit at Imperial College London said: “We found that although the NHS England Quality Premium on AMR succeeded in reducing broad spectrum antibiotic prescribing, resistance among E. coli causing bacteraemia remains on an upward trajectory, despite an initial attenuation. A multifactor, multisectoral, collaborative and global approach is needed, taking into consideration antibiotic use across the entire healthcare economy, in combination with a wider, ‘One Health’ approach, which involves efforts that work nationally and globally to improve health for people, animals and the environment.”

Co-author Shirin Aliabadi, a research postgraduate in the Global Digital Health unit at Imperial College London, and NHS Pharmacist said: “Antimicrobial resistance is predicted to kill 10 million people per year by 2050. Naturally, the nation’s efforts and resources have shifted to responding to the ongoing COVID-19 crisis but our findings suggest that we must nevertheless consider the growing threat of antimicrobial resistance, which can be viewed as a silent pandemic.”

Article by
Bryony Andrews

5th August 2021

From: Healthcare

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