This report reflects the findings of an inquiry into the links between antibiotic resistance and inadequate water, sanitation and hygiene facilities in healthcare settings across the world’s least developed countries.

It is the culmination of a collaboration between the All-Party Parliamentary Groups on Antibiotics, and Water, Sanitation and Hygiene (WASH).

From streams and lakes, to rivers and oceans, it’s clear antibiotics are making their way into our waters in ever greater concentrations, where they may exert a selective pressure on the development of resistant bacteria that’s present in our environment. This forms a vicious circle that’s increasing resistance rates and risking a rise in deadly superbugs.

Yet despite the potential implications for human health, current environmental risk assessment guidelines and regulations don’t take account of antibiotic resistance.

Following the publication of the UK Government’s 5-year action plan for antimicrobial resistance (AMR) 2019 to 2024, an evidence session on AMR was held jointly by the All-Party Parliamentary Group (APPG) on Antibiotics, the All-Party Pharmacy Group, and the APPG for Dentistry and Oral Health.

This session looked at the ways in which the primary care sector has so far helped to overcome the many complex challenges posed by AMR, and at what more needs to be done by health professionals, patients and the NHS to address these challenges – not least because AMR would appear to have far-reaching consequences for the burden of illness in the community, including common infections.

The work of the Medicines for Malaria Venture, to date, has shown that the ‘pipeline coordinator’ model can help to facilitate drug development. Its success, in terms of the number of drugs in the current portfolio, has relevance to antibiotic development too, and so this model deserves further investigation. This is the report of a meeting held jointly with the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases on 27th February, 2018.

In 2011 the World Health Organization (WHO) submitted a European Strategic Action Plan on Antibiotic Resistance to the WHO European Regional Committee with an aim of building on the momentum created by World Health Day. The Action Plan highlighted seven strategic objectives as guidance to national governments in European Member States to address the complex factors of antibiotic use and resistance. In response, both the European Union (EU) and the United Kingdom (UK) government set out to devise their own action plans to address the recommendations of the WHO policy document. This article reviews the recommendations in these three policy documents in the subject area of antibiotic resistance (AMR) and the extent to which they have been implemented in Europe and the UK.

Published Science in Parliament, Autumn 2014

Published Science in Parliament, Autumn 2013

Published Science in Parliament, Autumn 2011

This report of the All-Party Parliamentary Group on Antibiotics highlights current research activity in bacteriology and antibiotic research in the UK for the period 2008–13

Published Journal of Antimicrobial Chemotherapy, January 2015
Drug licensing is changing. Previously, regulators prioritized the licensing of innovative drugs that fulfilled a high unmet medical need for a small number of patients, including orphan, cancer and HIV medicines. Alternatives to large and costly prospective, randomized, double-blind clinical trials have led to a more bespoke development, such as adaptive design studies. Regulators have recently agreed to include much-needed narrow-spectrum antibiotics, active against certain MDR bacteria, in this paradigm. The background to why big pharmaceutical companies have largely deserted the antibacterial research arena, and the proposals that are hoped to reinvigorate their interest, are presented.

This report of the All-Party Parliamentary Group on Antibiotics highlights the use of antibiotics outside of human medicine and the need to restrict this practice to delay the selection and spread of antibiotic resistant bacteria.

This report of the  All-Party Parliamentary Group on Antibiotics asks if the global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a post-antibiotic world.  The extensive use of antibiotics outside clinical settings is often overlooked.  Given the current crisis, it is vital that the non-medical use of antibiotics is critically examined and that any non-essential use halted.

Published PLOS Biology, October 2015
The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted.