About the AMR local indicators

Data have been uploaded across six domains:

  • Supporting NHS England Initiatives
  • Antimicrobial Resistance (AMR)
  • Antibiotic Prescribing
  • Healthcare-Associated Infections (HCAI)
  • Infection Prevention and Control (IPC)
  • Antimicrobial stewardship (AMS)

Antibiotic prescribing and antibiotic resistance are inextricably linked, as overuse and incorrect use of antibiotics are major drivers of resistance. AMR local indicators are publically available data intended to raise awareness of antibiotic prescribing, AMR, HCAI, IPC and AMS; and to facilitate the development of local action plans. The data published in this tool may be used by healthcare staff, commissioners, directors of public health, academics and the public to compare the situation in their local area to the national picture.

For further information about this profile, please click here to download the user guide.

Updated indicators

May 2021 - The following indicators have been updated in the Profile: AMR Local Indicators:

Domain: Antibiotic Prescribing, Area: CCGs (since 4/2020)

  • Total number of prescribed antibiotic items per STAR-PU by quarter
  • Total number of prescribed antibiotics items per 1000 resident individuals by quarter
  • Percentage of broad - spectrum prescribed antibiotics items (cephalosporin, quinolone and co- amoxiclav class) by quarter
  • Twelve-month rolling proportion of trimethoprim class prescribed antibiotic items as a ratio of trimethoprim to nitrofurantoin
  • Twelve-month rolling total number of prescribed antibiotic items per 1000 resident individuals per day
  • Twelve-month rolling total number of prescribed antibiotic items per STAR-PU
  • Twelve-month rolling percentage of prescribed antibiotic items from cephalosporin, quinolone and co-amoxiclav class

Domain: Antibiotic Prescribing, Area: GP

  • Percentage of broad-spectrum prescribed antibiotic items (cephalosporin, quinolone and co-amoxiclav class) by quarter
  • Total number of prescribed antibiotic items per 1000 registered patients by quarter
  • Total number of prescribed antibiotic items per STAR-PU by quarter
  • Twelve-month rolling proportion of trimethoprim class prescribed antibiotic items as a ratio of trimethoprim to nitrofurantoin

The method of consultations in the community during the COVID-19 pandemic (from 2020) is likely to be different from the pre-pandemic period. Therefore, comparisons of the data before and during the pandemic should be treated with caution. Also please note that total antibacterial items have reduced over the COVID-19 period and will have had subsequent impacts on antibiotic proportions, where total antibacterial items has been used as the denominator.

Domain: Antibiotic Prescribing, Area: Acute Trusts

  • Total antibiotic prescribing DDDs per 1000 admissions; by quarter and trust
  • Carbapenem prescribing DDDs per 1000 admissions; by quarter and acute trust
  • Proportion of total antibiotic prescribing from the "Access" category of the WHO Essential Medicines List AWaRe index; by quarter and acute trust
  • Proportion of total antibiotic prescribing from the "Watch" category of the WHO Essential Medicines List AWaRe index
  • Proportion of total antibiotic prescribing from the "Reserve" category of the WHO Essential Medicines List AWaRe index

All Acute Trust level antibiotic prescribing indicators have been updated to Q3 2020/21. Reminder that indicators displaying the rate of Antibiotic Defined Daily Doses (DDDs) per 1000 admissions are now calculated using provisional HES admissions data for each quarter in question rather than proxy admissions for the most recent quarters, to be more representative of Trust activity experienced in this period. For a complete 2020/21 publication schedule please see the definitions tab for each Acute Trust level prescribing indicator.

April 2021 - The following indicators have been updated in the Profile: AMR Local Indicators:

Domain: Antimicrobial Resistance, Area: Laboratory 

  • Percentage of Neisseria gonorrhoeae isolates with susceptibility tests to azithromycin; by year
  • Percentage of Neisseria gonorrhoeae isolates with susceptibility tests to ceftriaxone; by year

Domain: Antimicrobial Stewardship, Area: CCGs

  • Antibiotic Guardians per 100,000 population per calendar year by CCGs
  • Antibiotic Guardians per 100,000 population per quarter by CCG

Domain: Antimicrobial Resistance Area: All Trust/All Clinical Commissioning Group

  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to a carbapenem; by CCG and by Quarter (2015 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to a 3rd Generation Cephalosporin (cefotaxime/ceftazidime/ceftriaxone/cefpodoxime); by CCG and by Quarter (2015 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to ciprofloxacin; by CCG and by Quarter (2015 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to gentamicin; by CCG and by Quarter (2015 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to piperacillin/tazobactam; by CCG and by Quarter (2015 Q1 onwards)
  • Rolling quarterly average proportion of E. coli blood specimens resistant to at least 1 from key antimicrobials (gentamicin, ciprofloxacin, piperacillin/tazobactam, 3rd-generation cephalosporins, carbapenems; from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Rolling quarterly average proportion of 'multi-drug resistant' E. coli blood specimens from key antimicrobials (gentamicin, ciprofloxacin, piperacillin/tazobactam, 3rd-generation cephalosporins, carbapenems; from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Rolling quarterly average proportion of 3rd generation cephalosporin resistant E. coli blood specimens (from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Rolling quarterly average proportion of ciprofloxacin resistant E. coli blood specimens (from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Rolling quarterly average proportion of gentamicin resistant E. coli blood specimens (from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Rolling quarterly average proportion of piperacillin/tazobactam resistant E. coli blood specimens (from English laboratories); by CCG and by Quarter (2015 Q4 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to gentamicin; by acute Trust and by Quarter (2016 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to a carbapenem; by acute Trust and by Quarter (2016 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to ciprofloxacin; by acute Trust and by Quarter (2016 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to piperacillin/tazobactam; by acute Trust and by Quarter (2016 Q1 onwards)
  • Percentage of E. coli blood specimens (from English laboratories) with susceptibility tests to a 3rd generation cephalosporin; by acute Trust and by Quarter (2016 Q1 onwards)
  • Rolling quarterly average proportion of ciprofloxacin resistant E. coli blood specimens (from English laboratories); by acute Trust and by Quarter (2016 Q1 onwards)
  • Rolling quarterly average proportion of 3rd generation cephalosporin resistant E. coli blood specimens (from English laboratories); by acute Trust and by Quarter (2016 Q1 onwards)
  • Rolling quarterly average proportion of piperacillin/tazobactam resistant E. coli blood specimens (from English laboratories); by acute Trust and by Quarter (2016 Q1 onwards)
  • Rolling quarterly average proportion of gentamicin resistant E. coli blood specimens (from English laboratories); by acute Trust and by Quarter (2016 Q1 onwards)
  • Percentage of community E. coli (or coliform) urine specimens with susceptibility tests to trimethoprim; by quarter
  • Percentage of community E. coli (or coliform) urine specimens non-susceptible to trimethoprim; by quarter
  • Percentage of community E. coli (or coliform) urine specimens with susceptibility tests to nitrofurantoin; by quarter
  • Percentage of community E. coli (or coliform) positive urine specimens non-susceptible to nitrofurantoin; by quarter

Antimicrobial Resistance (AMR): Testing and resistance indicators for E. coli blood stream and urinary tract infections were updated for the calendar quarter Q4 2020. Please note that following a PHE data infrastructure issue this data is provisional and may change when refreshed next quarter.

 

Interventions to reduce AMR

There are a number of actions that can be taken to reduce the burden of AMR. These include improved antibiotic prescribing as well as enhanced infection prevention and control, both for healthcare-associated and community-onset infections. The AMR resource handbook identifies current national policy, guidance and supporting materials in relation to antimicrobial stewardship and the infection prevention and control of healthcare associated infections in order to aid the reduction of antimicrobial resistance. 

Archived Indicators 

Archived Indicators

Recent updates

December 2020

Surveillance of surgical site infections in NHS hospitals in England annual Report for 2019 to 2020 

https://www.gov.uk/government/publications/surgical-site-infections-ssi-surveillance-nhs-hospitals-in-england 

November 2020

English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report for 2019 to 2020

Recent updates

December 2020

Surveillance of surgical site infections in NHS hospitals in England annual Report for 2019 to 2020 

https://www.gov.uk/government/publications/surgical-site-infections-ssi-surveillance-nhs-hospitals-in-england 

November 2020

English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report for 2019 to 2020