NICE is developing two new guidelines to help tackle the growing threat of antibiotic resistance. The first is on safe and effective antimicrobial stewardship in relation to the use of antimicrobials in health and social care, and the second is a public health guideline that will focus on changing people’s knowledge, attitudes and behaviors in relation to the use of antimicrobials.

A report by Public Health England found antibiotic prescriptions and cases of resistant bacteria in England have continued to rise despite continued warnings about unnecessary antibiotic use.

Public Health England found between 2010 and 2013 there was a 6% increase in the combined antibiotic prescribing of GPs and hospitals. Over the same four-year period, antibiotic prescribing to hospital inpatients rose by 12% and other community prescriptions, such as by dentists, rose by 32%.

According to the report, English Surveillance Program for Antimicrobial Utilization and Resistance (ESPAUR), there also was an increase of 12% in the number of bloodstream infections caused by E. coli with varying levels of resistance to key antibiotics for this infection of 10% to 19%.

Prime Minister David Cameron has warned the world will be "cast back into the dark ages of medicine" unless action is taken. Chief medical officer for England, professor Dame Sally Davies, has said antimicrobial resistance poses a “catastrophic threat” to the health of the nation.

Professor Mark Baker, director of clinical practice at NICE, said, “The ESPAUR report highlights how important antimicrobial stewardship is in ensuring antimicrobials are used safely and appropriately to manage the increasing challenge of antimicrobial resistance, which is a complex issue.”

He said, “Tackling antimicrobial resistance will require a concerted and coordinated effort by multiple national agencies, and effective implementation of what we know works to reduce it whilst promoting antimicrobial stewardship.”

“NICE is developing two guidelines which will support national efforts to reduce antimicrobial resistance,” said Baker. “The first is on antimicrobial stewardship focusing on specific questions relating to safe and effective antimicrobial stewardship in relation to the use of antimicrobials in health and social care and seeks to understand those interventions, systems and processes that can positively influence health and social care practitioners’ decision making. This includes identifying the barriers to effective stewardship, along with reviewing the systems and processes to reduce the emergence of antimicrobial resistance.”

Baker continued, “The second is a public health guideline that will focus on changing the public’s knowledge, attitudes and behaviors in relation to the use of antimicrobials, and to educate health and social care practitioners about practices that can reduce the spread of antimicrobial resistance. Together, these complementary guidelines should help to tackle this important issue.”

NICE also will develop a quality standard on antibiotic prescribing as part of a suite of new public health quality standards.