Antimicrobial resistance (AMR) is one of the biggest threats to global health. In 2019, resistant infections are estimated to have caused 1.27 million deaths and contributed to nearly 5 million more globally. In November I attended an RCN hosted AMR summit which provided a platform for leaders within this space to explore how nurses can help to make a difference.

Why is this important?

AMR isn't just a clinical issue - it's a public health emergency. If the numbers above did not make the case for action clearly enough, the O'Neill Review warned that, unchecked, AMR could drive 10 million deaths annually by 2050 with huge social and economic consequences. In 2024 in England we recorded 12,175 drug resistant bacteraemia, the majority of which were E. coli resistant to 3rd generation cephalosporins. That is not just a number, it represents suffering, with thousands of severely ill people who need more care for longer and many families and friends deeply affected by illness and loss. Looking to the future, many illnesses we can currently control could become almost untreatable, and many surgical procedures or immunosuppressant treatments which we rely on antibiotics to perform safely would be too dangerous to do.

Who does this affect?

The risk to health is clear, but there is also a significant issue of inequalities. In England UKHSA collect data on resistant bloodstream infections (BSI) and antimicrobial consumption by deprivation (IMD), ethnicity, age, gender and region. This data shows resistant BSI are most common in those from poorer backgrounds, older adults, global majority groups and those living in areas of poverty. Research has shown resistant infections are over 47% higher in areas of poverty than areas of affluence! All of this sounds scary, and it is. However, it is not hopeless. If we take concerted and coordinated action across the health system (and animal health system) globally, we can slow the growth of antimicrobial resistance while new antimicrobials are developed. As nurses we have an important part to play in this.

AMR Summit

From critical care to community practice, the AMR Summit underscored nursing's central role. Nurses are uniquely placed to steward antimicrobials, prevent infection, and communicate risk with people. We heard the thought-provoking experience of Vanessa Carter. Her recovery from a road accident was greatly affected over many years due to a highly resistant MRSA infection which resulted in periods of illness, extra surgeries and additional facial amputation. We looked at the policy context, with the UK/WHO strategy alignment, and explored practical tools for stewardship, including IV to oral switch (IVOS), community AMS, and incorporating updated NICE sepsis guidance. 

Why nurses?

AMR isn’t just a prescriber’s or patient problem. At bedsides and in the community, we nurses have far more – and often longer - patient contact than most other clinicians. This means we can see signs of infections developing and can monitor the effectiveness of treatment. We can work with patients to advocate on their behalf, support them to make decisions and educate them about complexities of treatments. As nurses are consistently one of the most trusted professions, we also have a voice  the public will listen to, including about AMR.

What can nurses do now?

In clinical practice:

• Support AMS: take good samples, give good quality assessments, use TARGET resources.
• Support prompt IV to oral switches for your patients.
• Sepsis: for the highest risk patients prompt treatment is essential, lower risk patients have a 1–3-hour window to clarify diagnosis and target therapy.
• Standard precautions: good line and catheter care, vaccination and hygiene reduce infection risk.

As members of the public (and with our families):

• Prevent infections: keep vaccinations up to date, practice hand hygiene at home, and use wound care and respiratory etiquette effectively especially in these winter months to avoid spreading illnesses.
• Seek help appropriately: use NHS 111, community pharmacy and primary care for timely advice—and accept when antibiotics aren’t indicated for viral illnesses.
• Use antibiotics correctly: if prescribed, take exactly as directed; don’t share or save antibiotics.

As trusted professionals in our communities:

• Promote sensible antibiotic use. Many common illnesses are viral or self-limiting and will see no benefits from antibiotics; reinforce self-care, red flags and when to seek help.
• Use your position as trusted professionals to promote public campaigns on AMR such as Keep Antibiotics Working and Antibiotic Guardian campaigns.
• Share your knowledge of healthcare and the importance of having effective antibiotics in your workplace to try and keep AMR a priority.
• Highlight the inequalities exposed by AMR and support policy measures to address this.

Nurses are part of the solution. Let's lead, educate, and advocate so future generations have antimicrobials that work.