406 a week, rising 3.2% instead of 9.3%: England's antibiotic-resistance ledger slows but does not turn

England’s UK Health Security Agency published its annual surveillance report on antibiotic use and resistance (ESPAUR) on Thursday, and the headline is a weekly number: an average of 406 antibiotic-resistant bloodstream infections reported each week in 2025¹. Over the year that came to 21,129 cases of resistant bacteraemia, up 16.8% from 18,086 in 2019¹.

The more interesting line is the slope. Cases rose by 3.2% between 2024 and 2025, from 20,468 to 21,129, against a 9.3% jump the year before¹. Estimated deaths among people with a resistant Gram-negative bloodstream infection were broadly level, at 2,318 in 2025 against 2,399 in 2024¹. Slower is not the same as falling, and UKHSA does not claim it is: “We can’t rely on reducing antibiotic use alone,” said Dr Shona Arora, its interim chief medical adviser¹.

The dull machinery is doing its job, though. Total NHS antibiotic use fell 10.7% between 2019 and 2025, from 17.8 to 15.9 defined daily doses per 1,000 inhabitants per day¹. Private prescriptions dispensed in community pharmacies, counted separately, fell 20.8% in a year, from 0.61 to 0.48¹. Preliminary analysis puts about 53,400 hospital admissions linked to Gram-negative bloodstream infections at around £800 million for NHS hospitals in 2023–24¹.

The burden is unequal. People over 45 accounted for 89.3% of resistant cases, and almost half were in people over 74¹. The most deprived areas had a rate of 44.4 per 100,000, against 30.8 in the least deprived, 44.2% higher¹. By care board, the range ran from 63.3 per 100,000 in North West London to 27.4 in Leicester, Leicestershire and Rutland¹.

For you, the agency’s advice is the ordinary kind: take antibiotics only when a health professional has told you to, do not save or share them, return leftovers to a pharmacy, and take up the vaccines you are offered, because an infection prevented needs no antibiotic at all¹.