There has been “no change in resistance” to a common UTI antibiotic following its introduction to the Pharmacy First service, the UK Health Security Agency (UKHSA) today (November 13) revealed.
A new UKHSA report on antimicrobial use and resistance in England for 2024/25 - which this year looked at antibiotic prescriptions from the Pharmacy First service for the first time - found “no change in resistance” to nitrofurantoin between 2023 and 2024 following its introduction to the service last February.
Nitrofurantoin is the antibiotic that can be supplied by pharmacists through Pharmacy First for the treatment of lower UTIs.
Read more: Pharmacy First to be ‘closely monitored’ for antimicrobial resistance risk
The findings follow Community Pharmacy England (CPE), NHS England (NHSE) and the government announcing in 2023 that they would be “closely monitoring the Pharmacy First service post-launch, particularly in relation to antimicrobial supply to guard against the risk of increasing antimicrobial resistance (AMR)”.
According to the report, primary care accounted for almost 80% of all antibiotics prescribed in 2024, of which just 4% came from Pharmacy First.
And for “antimicrobials defined within the Pharmacy First service pathways”, more than 80% of primary care usage in 2024 “occurred in the GP setting”, compared to just 5.4% under the Pharmacy First service, it said.
Read more: Pharmacy First: Sector must prove it can ‘manage’ antimicrobial stewardship
The report also found that while total antibiotic consumption in 2024 was “2% lower than the 2019 pre-pandemic level”, the introduction of Pharmacy First has driven a rise in antibiotic use in “other community” settings.
The service “now represents 34.5% of antibiotic use” in “other community” settings, “highlighting a significant change in how antibiotics are accessed in the community”, it added.
Interpret “with caution”
The report noted that while the rise in antibiotic use through the Pharmacy First service is “notable”, it “should be interpreted with caution” and “in the context of broader changes in how patients access care”.
It said that the service “follows established clinical protocols based on guidance from the National Institute for Health and Care Excellence (NICE) and diagnostic pathways developed by UKHSA supporting appropriate prescribing”.
“The observed increase may reflect a shift in patient pathways from other settings…rather than a simple increase in antibiotic demand,” it added.
“Vital stewards”
Professor Diane Ashiru-Oredope, UKHSA’s lead pharmacist for healthcare-associated infections and AMR, told C+D that community pharmacies “play a crucial role in our fight against antimicrobial resistance”.
“When pharmacists ensure thorough patient assessment, make appropriate prescribing decisions, provide clear guidance on when antibiotics aren’t needed and provide adequate information for patients prescribed antibiotics, they act as vital stewards of these medicines,” she said.
Read more: Pharmacy sore throat services provide antibiotics less than GPs, study reveals
It comes after pharmacists hit back at an open letter, written by a coalition of scientists to former Prime Minister Rishi Sunak in 2023, that claimed that enabling pharmacists to treat seven common ailments could lead to antibiotic resistance.
“We don’t accept the premise that allowing pharmacists to initiate antibiotics will increase AMR”, the National Pharmacy Association’s (NPA) director of corporate affairs Gareth Jones told C+D at the time.
Pharmacists are “highly trained and will only initiate treatment after careful consideration of the appropriate options”, he stressed.
