It is essential to focus on preventing infections to tackle AMR

Dr Diane Ashiru-Oredope

Lead Pharmacist, HCAI, Fungal, AMR, AMU & Sepsis Division UK Health Security Agency

Dr Susan Hopkins

Chief Medical Adviser, UK Health Security Agency

We are living through a global pandemic, with 5 million deaths associated with COVID since the start of 2020. However, the threat of antimicrobial resistance (AMR) continues to loom.

The Global AMR Review Study highlighted that 700,000 people die of antimicrobial resistant infections each year and that without urgent action, the death toll could rise to as many as 10 million deaths annually by 2050 causing e a 3.8% reduction in annual gross domestic product (GDP).

The World Health Organization declared AMR one of the 10 global health threats facing humanity in 2020.

Top 10 global threats to humanity 

We have seen how this pandemic is affecting the most vulnerable in our society, causing devastation to the most disadvantaged people. AMR is no different, making those living in low- and middle-income countries and the marginalised communities in high income countries disproportionately vulnerable. The World Health Organization declared AMR one of the 10 global health threats facing humanity in 2020.

COVID-19 is also exacerbating AMR. While co-infection of COVID-19 and bacterial infection remains low – 6·9% of those diagnosed with COVID-19, antibiotic prescribing occurred in more than 70% of patients diagnosed with COVID-19 infection. These actions can worsen the state of AMR as a result of overuse of antibiotics due to the pandemic.

Antimicrobial consumption and resistance during the pandemic

The data from the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) shows that antibiotic consumption in the community reduced during the initial stages of the pandemic. This highly correlated with reductions in other seasonal respiratory infections due to reductions in social mixing and changes in health seeking behaviour, access and delivery. 

However, the use of antibiotics, especially antibiotics of last resort, increased in hospitals as well as the proportion of bloodstream infections detected with resistance to one or more antibiotics.

Continuing education of good practise 

Although competing priorities to deal with the pandemic have led to reduced focus on strategies to tackle antimicrobial resistance specifically, the enhanced focus on infection prevention and control to prevent COVID-19 will prevent other infections avoiding the need for antibiotics. 

We need to continue to educate and inform the public and healthcare workers on how infections develop through the chain of infection and breaking it through practices such as good handwashing, catching coughs and sneezes (including the use of face coverings) and regular cleaning at home, in the office and in healthcare settings. 

It is important that the public and healthcare professionals continue to focus on reducing the incidence of infections and subsequent development of antibiotic resistant infections.