Resistant infections and health inequalities

There is emerging evidence of increased rates of infection and resistant infection, as well as higher levels of antimicrobial exposure, in individuals with factors commonly associated with health inequalities.

Ethnic minorities, deprived individuals and inclusion health groups, such as vulnerable migrants (including asylum seekers and refugees, unaccompanied asylum-seeking children, people who have been trafficked, undocumented migrants i.e. those who are living in the UK with no legal status, as well as low paid migrant workers), have consistently been shown to be at higher risk of infections, including TB, sexually transmitted diseases and MSSA.

Higher levels of antibiotic use have also been identified within groups such as older adults, especially those in residential care and living in areas with higher levels of deprivation.

Vulnerable migrants often rely on alternative routes of antibiotic supply owing to barriers faced in accessing healthcare within the UK. This may lead to higher rates of inappropriate antibiotic use in this population.

Resistance risk

A meta-analysis has highlighted that the risk of resistance persists for at least 12 months in individuals after each intake of an antibiotic. Healthy people who have not had contact with healthcare services can carry resistant bacteria, which could then spread from person to person in the community or from patient to patient in hospital.

In England, 80 per cent of antibiotic prescriptions were supplied to patients residing in the community in 2022. General practices accounted for 72 per cent of consumption, dental practices 4 per cent and other community settings 4 per cent.

Hospital inpatients and outpatients account for 13 and 7 per cent of antibiotic prescriptions respectively.