About the AMR local indicators

Data have been uploaded across six domains: The AMR local indicators are produced by the UKHSA.

  • 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

April 2022

Topic: Antibiotic Prescribing, Area: CCGs (from April 2021) for Q4 2021

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

Topic: Antibiotic Prescribing, Area: GP for Q4 2021

  1. Percentage of broad-spectrum prescribed antibiotic items (cephalosporin, quinolone and co-amoxiclav class) by quarter
  2. Total number of prescribed antibiotic items per 1000 registered patients by quarter
  3. Total number of prescribed antibiotic items per STAR-PU by quarter
  4. 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."

 

March 2022 - The following indicators have been updated in the Profile: AMR Local Indicators:

Topic: Healthcare Associated Infections, Area: (Acute Trusts, CCGs from April 2021) have been updated for up to February 2022.

Topic: Antimicrobial Resistance, Area: All Acute Trusts up to Q4 2021

E.coli, blood, resistance, Ciprofloxacin, rolling quarterly, %
E.coli, blood, resistance, 3rd generation cephalosporin, rolling quarterly, %

E.coli, blood, resistance, piperacillin/tazobactam, rolling quarterly, %

E. coli, blood, resistance, Gentamicin, quarterly, %

E. coli, blood, testing, Gentamicin, quarterly, %
E. coli, blood, testing, carbapenem, quarterly, %
E. coli, blood, testing, Ciprofloxacin, quarterly, %
E. coli, blood, testing, piperacillin/tazobactam, quarterly, %

E. coli, blood, testing, 3rd generation cephalosporin, quarterly, %

"Also note that for a number of AMR local indicators, overall values for England are not currently displayed in the Data view Trends charts, or in some instances is shown for the latest quarter only and not for prior quarters. This will be rectified for the next upload in April 2022."

 

February 2022 - The following indicators have been updated in the Profile: AMR Local Indicators: 

Topic: Healthcare Associated InfectionsArea: (Acute Trusts, CCGs from April 2021) have been updated for up to January 2022.

Topic: Antimicrobial Resistance, Area: All Clinical Commissioning Group from period up to Q4 2021

CCG's

E. coli, blood, testing, carbapenem, quarterly, %
E. coli, blood, testing, 3rd generation cephalosporin, quarterly, %
E. coli, blood, testing, Ciprofloxacin, quarterly, %
E. coli, blood, testing, Gentamicin, quarterly, %
E. coli, blood, testing, piperacillin/tazobactam, quarterly, %
E. coli, urine, testing, trimethoprim, quarterly, %, community
E. coli, urine, resistance, trimethoprim, quarterly, %, community
E. coli, urine, testing, nitrofurantoin, quarterly, %, community
E. coli, urine, resistance, nitrofurantoin, quarterly, %, community
E.coli, blood, resistance, 1 Antibiotics, rolling quarterly, %
E.coli, blood, resistance, 3 or more antibiotics classes, rolling quarterly, %
E.coli, blood, resistance, 3rd generation cephalosporin, rolling quarterly, %

E.coli, blood, resistance, Ciprofloxacin, rolling quarterly, %
E.coli, blood, resistance, Gentamicin, rolling quarterly, %
E.coli, blood, resistance, piperacillin/tazobactam, rolling quarterly, %

"Also note that for a number of AMR local indicators, overall values for England are not currently displayed in the Data view Trends charts, or in some instances is shown for the latest quarter only and not for prior quarters. This will be rectified for the next upload in April 2022."

 

January 2022 - The following indicators have been updated in the Profile: AMR Local Indicators: 

Topic: Antibiotic Prescribing, Area: CCGs (from April 2021) for Q3 2021

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

Topic: Antibiotic Prescribing, Area: GP for Q3 2021

  1. Percentage of broad-spectrum prescribed antibiotic items (cephalosporin, quinolone and co-amoxiclav class) by quarter
  2. Total number of prescribed antibiotic items per 1000 registered patients by quarter
  3. Total number of prescribed antibiotic items per STAR-PU by quarter
  4. 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 for Q2 2021/22

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

Topic: Supporting NHS England Initiatives, Area: Acute Trusts

  • Proportion of total antibiotic prescribing from the "Watch" and "Reserve" categories of the WHO Essential Medicines List AWaRe index

All Acute Trust level antibiotic prescribing indicators have been updated to include Q2 2021/22. 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 2021/22 publication schedule please see the definitions tab for each Acute Trust level prescribing indicator.

A new indicator has been added to allow Trusts to easily track combined usage of Watch and Reserve drugs as a percentage of total use. This indicator can be found in the Supporting NHS England Initiatives domain, and is titled ‘Proportion of total antibiotic prescribing from the "Watch" and "Reserve" categories of the WHO Essential Medicines List AWaRe index’.

  • Indicators in the Topic: Healthcare Associated InfectionsArea: Acute Trusts, CCGs (from April 2021) have been updated for up to November 2021

 

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

January 2022

Paper on (Increased mortality in COVID-19 patients with fungal co- and secondary infections admitted to intensive care or high dependency units in NHS hospitals in England) Increased mortality in COVID-19 patients with fungal co- and secondary infections admitted to intensive care or high dependency units in NHS hospitals in England - ScienceDirect

December 2021

Paper on respiratory antibacterial prescribing in primary care and the COVID-19 pandemic in England, winter season 2020–21:  https://doi.org/10.1093/jac/dkab443 .

November 2021 

The eighth report from the English Surveillance Programme for Antimicrobial Use and Resistance (ESPAUR) was published on Wednesday 17th November, ahead of World Antimicrobial Awareness week (18th to 24th November).

The report updates on antibiotic usage and antimicrobial resistance in key bacterial and fungal pathogens covering the 2020 pandemic period. Also included in the report are discussions on interventions related to antimicrobial stewardship, public and professional education and training delivered, as well as a review of research being undertaken and the ‘Keep Antibiotics Working’ campaign.

The report and all data appendices are available from https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report

Paper on trends in rates of Antimicrobial Resistance among isolates of Pseudomonas spp. : https://authors.elsevier.com/sd/article/S0195-6701(21)00411-4

Paper on first wave of coinfections: National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave - Clinical Microbiology and Infection

Recent updates

January 2022

Paper on (Increased mortality in COVID-19 patients with fungal co- and secondary infections admitted to intensive care or high dependency units in NHS hospitals in England) Increased mortality in COVID-19 patients with fungal co- and secondary infections admitted to intensive care or high dependency units in NHS hospitals in England - ScienceDirect

December 2021

Paper on respiratory antibacterial prescribing in primary care and the COVID-19 pandemic in England, winter season 2020–21:  https://doi.org/10.1093/jac/dkab443 .

November 2021 

The eighth report from the English Surveillance Programme for Antimicrobial Use and Resistance (ESPAUR) was published on Wednesday 17th November, ahead of World Antimicrobial Awareness week (18th to 24th November).

The report updates on antibiotic usage and antimicrobial resistance in key bacterial and fungal pathogens covering the 2020 pandemic period. Also included in the report are discussions on interventions related to antimicrobial stewardship, public and professional education and training delivered, as well as a review of research being undertaken and the ‘Keep Antibiotics Working’ campaign.

The report and all data appendices are available from https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report

Paper on trends in rates of Antimicrobial Resistance among isolates of Pseudomonas spp. : https://authors.elsevier.com/sd/article/S0195-6701(21)00411-4

Paper on first wave of coinfections: National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave - Clinical Microbiology and Infection