Phoenix 24
Fewer prescriptions have not stopped resistant infections from rising.
LONDON, England. England recorded 21,129 antibiotic-resistant bloodstream infections in 2025, equivalent to an average of 406 cases every week, according to new surveillance data released by the UK Health Security Agency (UKHSA). The findings reveal a persistent public health challenge: resistant infections continue to increase even as the National Health Service reduces antibiotic consumption.
The figures, published in the latest English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report, represent a 16.8% increase from the 18,086 cases documented in 2019. Although the number of infections remains elevated, their annual growth rate slowed to 3.2% between 2024 and 2025, compared with 9.3% during the previous year.
The surveillance focuses on antibiotic-resistant bacteraemia, a condition in which bacteria enter the bloodstream and may cause serious or potentially life-threatening complications. The figures therefore represent a specific category of resistant infections rather than every case of antimicrobial resistance occurring across England.
The increase has continued despite measurable progress in reducing antibiotic use. Between 2019 and 2025, antibiotic consumption within the NHS declined by 10.7%, from 17.8 to 15.9 defined daily doses per 1,000 inhabitants per day. Private antibiotic consumption through community pharmacies also fell by 20.8% between 2024 and 2025.
These contrasting trends underscore the complexity of antimicrobial resistance. Reducing unnecessary prescriptions is an important preventive measure, but resistant bacteria can continue circulating through hospitals, communities and other environments. Infection prevention, effective surveillance and the development of new treatments therefore remain essential components of the public health response.
The consequences extend beyond the number of reported infections. UKHSA estimated that 2,318 people who experienced resistant Gram-negative bloodstream infections died in 2025, compared with 2,399 in 2024. These figures concern deaths among affected patients and should not be interpreted as proof that antimicrobial resistance directly caused every death.
The report also identifies significant demographic and socioeconomic inequalities. Adults aged over 45 accounted for 89.3% of resistant infection cases, while nearly half occurred among people older than 74. Advanced age, underlying health conditions and greater exposure to medical interventions can increase vulnerability to serious bacterial infections.
Economic deprivation presents another important dimension. Residents of England’s most deprived communities experienced resistant bloodstream infection rates 44.2% higher than those living in the least deprived areas. The respective rates were 44.4 and 30.8 cases per 100,000 people, highlighting differences that require targeted investigation and prevention.
Geographical disparities were also substantial. NHS North West London recorded 63.3 resistant bloodstream infections per 100,000 inhabitants, compared with 27.4 in Leicester, Leicestershire and Rutland. Such differences may reflect multiple factors, including population characteristics, healthcare exposure and local patterns of infection, rather than a single identifiable cause.
The financial burden is considerable. Preliminary analysis suggests that approximately 53,400 hospital admissions associated with Gram-negative bloodstream infections generated around £800 million in hospital costs during 2023 and 2024. That estimate covers the broader category of infections and does not represent expenditure attributable exclusively to antibiotic resistance.
UKHSA officials emphasized that responsible prescribing remains necessary but cannot independently reverse the trend. Public health measures must also prioritize vaccination, infection control, appropriate treatment decisions and continued research into therapeutic alternatives.
The findings reinforce the importance of England’s national antimicrobial resistance action plan for 2024 to 2029, which seeks to strengthen prevention, surveillance and responsible antimicrobial use. Progress will depend on translating these priorities into measurable improvements across hospitals and communities, particularly among populations facing the greatest risk.
For healthcare systems internationally, England’s experience illustrates a critical distinction between reducing antibiotic consumption and reducing the burden of resistant disease. Both objectives are connected, but success in one does not guarantee immediate progress in the other.
Beyond the Numbers, the Consequences.