World Antimicrobial Awareness Week: How the NHSBSA is supporting the fight against antimicrobial resistance

Since Alexander Fleming’s discovery of penicillin in 1928, when he saw that where mould had grown in his petri dishes bacterial colonies were absent, we’ve grown up in the comfortable knowledge that we can rely on antibiotics to treat the mildest earache to the most severe pneumonia.

Increasingly, however, that is no longer the case.

Our often unnecessary reliance on antibiotics, in the treatment of both humans and animals, means that our antibiotics are no longer as effective at treating infections as they once were, and resistance is building to them – referred to as antimicrobial resistance (AMR).

And not only are our existing antibiotics losing their effectiveness but we’re also not developing new treatments for these increasingly resistant infections.

AMR is a global problem that impacts all countries and people, regardless of wealth or status.

There is no single solution and it will require the collective efforts of us all to make sure future generations have the benefit of effective treatment. This includes:

• Reducing the use of antibiotics in humans and food-producing animals and, when we do use them, using them optimally - the correct dose and duration
• Having an increased focus on prevention of illnesses and vaccination to reduce the risk of developing infections in the first place that will require treatment, and
• Changing the approach with pharmaceutical companies to incentivise the development of new drugs to treat resistant infections.

The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by governments, international agencies, researchers, and private companies alike.

The Department of Health and Social Care set out in 2019 a five-5-year national action plan and a 20-year vision to tackle AMR which builds on the Antimicrobial Resistance Strategy (2013-2018). The need for progress is also reflected in the NHS Long Term Plan published in 2019.

The UK five-year action plan ‘Tackling antimicrobial resistance 2019 to 2024’, focuses on three key ways of tackling AMR:

• Reducing need for, and unintentional exposure to, antimicrobials
• Optimising use of antimicrobials
• Investing in innovation, supply and access

NHS Business Services Authority (NHSBSA) responded to help tackle the problem and support the strategy by first developing the Antimicrobial Stewardship dashboard, which allows ePACT2 users to monitor the prescribing of antibiotics. This work was carried out in conjunction with NHS RightCare as part of its RightCare Urinary Tract Infection Data Pack, Public Health England, and the NHS Antimicrobial Resistance programme.

To increase our support for the strategy and impact on AMR, the NHSBSA has launched the new ‘Antimicrobial Stewardship (AMS) – Children Dashboard’. This new dashboard follows the guidance of this strategy to now monitor antimicrobial prescribing for children aged between 0-14 years.

The purpose of the dashboard is to allow NHS organisations to:

• See the variation in antibiotic prescribing for children aged 0-14 years
• Compare antibiotic prescribing rates over time and between organisations
• Understand how many children are prescribed one or more antibiotics
• Identify and prioritise opportunities for antimicrobial stewardship improvement
• Monitor and report antimicrobial stewardship improvement

In 2019-20 (financial year) around 30 million antibiotic prescription items were dispensed in primary care. Children aged 0-14 years accounted for 3.6 million (12%) of these items, of which 48% was prescribed to children aged 0-4 years. Amoxicillin is the most common antibiotic prescribed to children and accounts for 53% of all antibiotic use in 0-4 year-olds.

The ePACT2 Training team will be delivering sessions focused on this new ‘AMS - Children Dashboard’ - to book go to the booking calendar.

More information about the AMS – Children Dashboard can be found on our website.

While this is a global problem, we can all play a part in tackling the problem of AMR. For instance:

• Practice infection prevention by getting vaccinated and continuing to use the basic infection control measures that we have become familiar with during COVID-19 – washing hands regularly, catching coughs and sneezes, staying at home when unwell.
• Be prepared to accept alternative treatments to support recovery from minor infections
• If prescribed antibiotics – take them as prescribed and finish the course.