Antibiotic-resistant bloodstream infections in England rose to 21,129 in 2025, but the rise slowed, UKHSA says

Antibiotic-resistant bloodstream infections in England kept rising in 2025, though more slowly than the year before, the UK Health Security Agency (UKHSA) said on November 12, 2026, in its annual report on antibiotic use and resistance. The agency counted 21,129 resistant cases of bacteraemia, an infection in which bacteria are present in the bloodstream, or an average of 406 a week. That was 3.2% more than the 20,468 cases recorded in 2024, after a 9.3% rise the year before, and 16.8% more than the 18,086 recorded in 2019.

The report, known as ESPAUR, for English surveillance programme for antimicrobial utilisation and resistance, estimates that 2,318 people with a resistant Gram-negative bacteraemia died in 2025, broadly level with 2,399 in 2024. It also shows NHS antibiotic use still falling. UKHSA called that a positive sign but said it is not enough on its own. “We can’t rely on reducing antibiotic use alone,” said Dr. Shona Arora, the agency's interim chief medical advisor, adding that infections must also be prevented in the first place.

Who is hit hardest

Older people carry most of the burden. Adults over 45 accounted for 89.3% of resistant cases in 2025, and almost half were in people over 74. The gap between poor and better-off areas has grown. People in the most deprived fifth of areas had a 44.2% higher rate of resistant bacteraemia than those in the least deprived, at 44.4 against 30.8 cases per 100,000 people, up from a gap of 29.0% in 2019. Over the same period the gap in all bloodstream infections narrowed, from 28.4% to 23.6%.

The share of bloodstream infections that were resistant was 42.4% in the Asian or Asian British ethnic group and 32.8% in the Black, African, Caribbean or Black British group, against 20.7% in the White group, UKHSA said. Rates also varied widely between local health areas, from 63.3 per 100,000 people in NHS North West London to 27.4 in NHS Leicester, Leicestershire and Rutland.

Which bacteria and which drugs

Enterobacterales, the group that includes E. coli, K. pneumoniae and K. oxytoca, accounted for 85.5% of resistant bacteraemia episodes. E. coli made up around 70% of the burden over the past seven years, but the share of Klebsiella pneumoniae has grown, and among priority pathogens its bloodstream infections rose most, by 28% between 2019 and 2025. Resistance rose across most antibiotic classes in both species, most sharply for piperacillin with tazobactam in K. pneumoniae.

Measured against 2019 to 2020, the baseline of the UK's national action plan on antimicrobial resistance, specified drug-resistant infections in England were up 25.7%; the plan aims to prevent any increase in them by 2029. Fungal bloodstream infections also kept increasing, the report says, and the fungus Candidozyma auris remained an important cause of healthcare-associated infection, with outbreaks concentrated in London and south-east England.

Antibiotic use keeps falling

Total NHS antibiotic use was 15.9 defined daily doses per 1,000 inhabitants per day in 2025, 6.1% lower than in 2024. The national action plan for 2024 to 2029 aims to cut human antibiotic use by 5% from its 2019 to 2020 baseline by 2029. England's use in 2025 was 10.6% below that baseline, which UKHSA says means the target has been achieved ahead of schedule. General practice, which accounts for 65.4% of use, drove the fall, with consumption 18.8% below 2019, while hospital use was 5.4% higher than in 2019. Private prescriptions dispensed in community pharmacies, which are not in the NHS total, fell 20.8% between 2024 and 2025.

Another target is not yet met. The plan aims for 70% of antibiotic use to come from the Access category of the UK-adapted AWaRe classification by 2029; the share rose from 61% in 2019 to 65.6% in 2025. The report also puts a price on the problem: a preliminary analysis estimates that about 53,400 hospital admissions related to Gram-negative bloodstream infections cost NHS hospitals around £800 million between 2023 and 2024.

UKHSA asked the public to take antibiotics only when told to by a healthcare professional, not to save or share them, and to take leftovers to a pharmacy for disposal.