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Susan hopkins ag 2018

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Susan hopkins ag 2018

  1. 1. Progress on the Government’s ambitions to tackle AMR and Reducing inappropriate prescribing by 50% Susan Hopkins Deputy Director, National Infection Service, Public Health England HCAI & AMR Division NICE Annual Conference 2018
  2. 2. Disclaimers Chair of English Surveillance Programme on Antibiotic Utilisation and Resistance Oversight Group Member of MHRA anti-infectives group Member of NICE common infections guideline group Member of ECDC working groups Partially funded by NIHR HPRU for HCAI & AMR (Oxford and Imperial) No pharma sponsorship
  3. 3. Current situation
  4. 4. Future Source: Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations – The Review on Antimicrobial Resistance Chaired by Jim O’Neill
  5. 5. Infectious caused 32% deaths in 1901 3% in 2015
  6. 6. Due to improvements in 1. Sanitation 2. Immunisation 3. Treatment of infection Due to improvements in 1. Heart disease treatment 2. Cancer treatment, including surgery
  7. 7. Exposure toAntibiotics high Number of antibiotics % of population (33%) % in care homes (65%) 1 17% 26% 2 7% 14% 3 3% 8% 4 2% 5% >4 4% 12%
  8. 8. UK-Russia (Moscow), 18th December 2015 © Crown Copyright
  9. 9. Antibiotic resistance emerges shortly after (sometimes before) antibiotics used
  10. 10. Resistant bacteria detected rapidly UK-Russia (Moscow), 18th December 2015 © Crown Copyright
  11. 11. UK-Russia (Moscow), 18th December 2015 © Crown Copyright
  12. 12. 181,818,000 34,832,000 9,787,000 4,713,00066,181,585 Who lives in the UK? Horses 1.3 million; Dogs: 9 million; Cats: 7.9 million; Rabbits: 1 million; Fish kept in tanks: 25 million; Fish kept in ponds: 20 million; Caged birds: 1 million; Guinea Pigs: 0.5 million; Hamsters: 400,000; Lizards: 400,000
  13. 13. 14
  14. 14. National toolkits & training for professionals
  15. 15. Incentives: QualityPremium CommissioningforQuality&innovation Location Indicator Hospital Antibiotic review and assessment for antibiotics started for sepsis Hospital Reduction in total antibiotic consumption per 1,000 admissions Hospital Reduction in broad (carbapenem & pip/tazobactam) antibiotic consumption per 1,000 admissions Hospital Increase in Access group from EML Community Reduce antibiotic prescribing levels (0.965 items/STARPU) Community Reduction in Trimothoprim : Nitrofurantoin Community Reduce/ remain broad spectrum antibiotics <10% Dr Diane Ashiru-Oredope
  16. 16. Long term trends inAntibiotic Use AMR Local Indicator
  17. 17. Hospital Prescribing AMR Local Indicator
  18. 18. Defined Daily Dose (WHO) per 1000 population per day 2010 2014 2017 21.3* 22.8 21.2 Antibiotic Consumption * Estimated as only 6 months Dental data available
  19. 19. Open access
  20. 20. Joint ECDC/ EC One-Health country visit on Antimicrobial Resistance (AMR)
  21. 21. Joint ECDC/ EC One-Health country visit on Antimicrobial Resistance (AMR)
  22. 22. AMR = wicked problem Y&H AMR Programme Board highly impervious to resolution, difficult to define, arise form inter-dependent and multicausal factors and socially complex

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