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

September 2021 - The following indocators have been updated in the Profile: AMR Local Indicators: 

Topic: 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

Topic: 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

All indicators in the Topic: Healthcare Associated Infections, Area: Acute Trusts, CCGs (2018/19), CCGs (from April 2021) have been updated.

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

Topic: 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 Q4 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.

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

Topic: 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

Topic: 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."

Topic: Antimicrobial Resistance, Area: All Trust / All Clinical Commissioning Group (since 2015)

  • 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 Q1 2021. Please note that following a PHE data infrastructure issue this data is provisional and may change when refreshed next quarter.

Please note: the latest data upload (for calendar quarter Q2 2021) for all CCG and Trust level E coli BSI Antimicrobial Resistance (AMR) indicators has been delayed until 3rd November 2021. This is due to recent complex organisation mergers and ongoing processing required to incorprate these in to the data.

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

Topic: 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

Topic: 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.

Topic: 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.

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

July 2021

Article on the Surveillance of Antibacterial Usage during the COVID-19 Pandemic in England, 2020: https://www.mdpi.com/2079-6382/10/7/841

June 2021

Weekly notification totals of carbapenemase-producing Gram-negative bacteria, by mechanism and species, are now available through the weekly NOIDs reports. More information can be found at the link below: https://www.gov.uk/government/publications/health-protection-report-volume-15-2021/hpr-volume-15-issues-8-9-and-10-news-21-june-2021 

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: https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report

Recent updates

July 2021

Article on the Surveillance of Antibacterial Usage during the COVID-19 Pandemic in England, 2020: https://www.mdpi.com/2079-6382/10/7/841

June 2021

Weekly notification totals of carbapenemase-producing Gram-negative bacteria, by mechanism and species, are now available through the weekly NOIDs reports. More information can be found at the link below: https://www.gov.uk/government/publications/health-protection-report-volume-15-2021/hpr-volume-15-issues-8-9-and-10-news-21-june-2021 

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: https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report