Campaign urges people to 'Keep Antibiotics Working'

People being urged to take antibiotics only when necessary
People being urged to take antibiotics only when necessary

23 October 2017 

  • At least 5,000 deaths a year in England estimated to be caused because antibiotics no longer work for some infections[i] ,[ii]
  • New report from PHE reveals four in 10 patients with an E. coli bloodstream infection in England cannot be treated with the most commonly used antibiotic in hospitals
  • ‘Keep Antibiotics Working’ campaign warns that taking antibiotics when not needed puts people at risk of a more severe or longer infection

As the Chief Medical Officer and experts around the world warn of a “post-antibiotic apocalypse” and “the end of modern medicine,” Public Health England has today, 23 October, launched a major new campaign in the West Midlands region to help ‘Keep Antibiotics Working’.

The campaign warns people that taking antibiotics when they are not needed puts them at risk of a more severe or longer infection, and urges people to take their doctor’s advice on antibiotics. 

Within the West Midlands, work is underway to educate children and young people about the importance of antimicrobial resistance, with a partnership between NHS Birmingham CrossCity Clinical Commissioning Group (CCG), Heart of England NHS Foundation Trust (HEFT), Aston University, Birmingham City Council and Public Health England (PHE).

Public Health England’s ESPAUR [1] report, published today, reveals that as antibiotic resistance grows, the options for treatment decrease. Worryingly, 4 in 10 patients with an E. coli bloodstream infection in England cannot be treated with the most commonly used antibiotic in hospitals.

Antibiotics are essential to treat serious bacterial infections, such as meningitis, pneumonia and sepsis, but they are frequently being used to treat illnesses, such as coughs, earache and sore throats that can get better by themselves. Taking antibiotics encourages harmful bacteria that live inside you to become resistant. That means that antibiotics may not work when you really need them. It is estimated that at least 5,000 deaths are caused every year in England because antibiotics no longer work for some infections and this figure is set to rise with experts predicting that in just over 30 years antibiotic resistance will kill more people than cancer and diabetes combined.[iii]

The ‘Keep Antibiotics Working’ campaign urges people in the West Midlands region to always trust their doctor, nurse or pharmacist’s advice as to when they need antibiotics and if they are prescribed, take antibiotics as directed and never save them for later use or share them with  others. The campaign also provides effective self-care advice to help individuals and their families feel better if they are not prescribed antibiotics.

  Dr Musarrat Afza, PHE West Midlands health protection consultant, said: “Antibiotics are essential to treat serious bacterial infections, such as meningitis, pneumonia, but they are frequently used inappropriately for illnesses on which they have no effect – such as colds and flu, which are caused by viruses. Many viral infections are ‘self-limiting’, which means they will resolve by themselves, and the person with the illness can just treat symptoms of aching, soreness, headaches and slightly raised temperature with over-the-counter remedies. For a more serious viral illness, an anti-viral medicine may be given – but not antibiotics.

“Taking antibiotics, when you don’t need them means they could be less effective in fighting the next bacterial infection you get. Over-use of antibiotics gives rise to more and more resistant strains of bacterial infections, and this may eventually result in a world where our antibiotics simply can’t cure people anymore. So, to ‘Keep Antibiotics Working’ for you and your family, always take your doctor’s advice.”

In advance of PHE’s Keep Antibiotics Working campaign, a poster competition  for school children in Birmingham and the surrounding areas was launched by a partnership led and funded by Aston University,. There are two categories; for pupils from primary schools in years 3 to 6, and students in all years at secondary school. Posters must show why it’s important to ‘Keep Antibiotics Working’ and incorporate some of the key messages, such as washing hands and only using antibiotics when prescribed. The deadline for entries is Friday 27 October, and prizes will be awarded to the winners of each category. The two winning designs will go on display in healthcare settings across Birmingham. 

Rabia Ahmed, Pharmacy Teaching Fellow in the School of Life and Health Sciences, Aston University, said: "Keeping antibiotics working is of vital importance to global health. Aston University is proud to be part of this work with partners, particularly in engaging children and young people in the key messages around antibiotic resistance. 

"This is an excellent opportunity to encourage children to see the impact they can have on not only their health but others. We look forward to judging poster entries from these budding future scientists."

Rakhi Aggarwal, Antibiotic Lead Pharmacist at NHS Birmingham CrossCity CCG, said: “We are very excited to be a partner in this innovative project. The children and young people of today will be greatly affected by the consequences of antimicrobial resistance, if we can’t keep antibiotics working. It is very important that their voices are heard, to highlight the need for the appropriate use of antimicrobial drugs from a different perspective. 

“We hope that the competition entrants have enjoyed unleashing their creative talents to highlight this vital public health message. By educating Birmingham’s children and young people, we hope that the important message about antimicrobial resistance will also be shared with their families and friends.”

Public Health England’s new campaign is part of a wider cross-Government strategy, involving the agricultural, pharmaceutical and healthcare sectors, which tackles the threat of antibiotic resistance by increasing supply and reducing inappropriate demand. To help keep this precious resource in the fight against infections working, the public are asked to play their part and urged to always take their doctor, nurse or pharmacist’s advice on antibiotics.

Paul Cosford, Medical Director at Public Health England, commented: “Antibiotic resistance is not a distant threat, but is in fact one of the most dangerous global crises facing the modern world today. Taking antibiotics when you don’t need them puts you and your family at risk of developing infections which in turn cannot be easily treated with antibiotics. Without urgent action from all of us, common infections, minor injuries and routine operations will become much riskier. PHE’s ‘Keep Antibiotics Working’ campaign helps to explain the risks of antibiotic resistance to the public. It is important for people to understand that if they are feeling under the weather and see their GP or a nurse, antibiotics may not be prescribed if they are not effective for their condition, but they should expect to have a full discussion about how to manage their symptoms.”

Professor Dame Sally Davies, Chief Medical Officer, commented: “Without effective antibiotics, minor infections could become deadly and many medical advances could be at risk; surgery, chemotherapy and caesareans could become simply too dangerous. But reducing inappropriate use of antibiotics can help us stay ahead of superbugs. The public has a critical role to play and can help by taking collective action. I welcome the launch of the ‘Keep Antibiotics Working’ campaign, and remember that antibiotics are not always needed so always take your doctor’s advice.”

For further information on antibiotics, their uses and the risk of resistance, please search ‘NHS Antibiotics’ online.

  [1] English Surveillance Programme for Antimicrobial Utilisation and Resistance Report

For more information/interviews please contact PHE West Midlands press office on 0121 232 9223 / 9224, or out of hours on 07834 311 393.


Notes to the editor

1 .Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities.  It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health.

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  • The campaign is part of a wider cross-Government strategy to help preserve antibiotics. The Government’s ‘UK Five Year Antimicrobial Resistance Strategy 2013 to 2018’ set out aims to improve the knowledge and understanding of AMR, conserve and steward the effectiveness of existing treatments, and stimulate the development of new antibiotics, diagnostics and novel therapies. In July 2014, the Prime Minister announced a review of antimicrobial resistance chaired by the economist Jim O’Neill. The subsequent report, published in 2016, recommended a number of actions to be taken globally to manage the rise of antimicrobial resistance, including public awareness campaigns.
  • PHE’s ‘Keep Antibiotics Working’ campaign targets the general public and is aligned Antibiotic Guardian which urges healthcare professionals and engaged members of the public to take one of a number of pledges to help personal and organisational commitment to preserve antibiotics at
  • The campaign runs from Monday 23 October across England for eight weeks and will be supported with advertising, partnerships with local pharmacies and GP surgeries, and social media activity.
  • Use this link to download all campaign assets including the TV advert and imagery.
Additional data from Public Health England’s English Surveillance Programme for Antimicrobial Utilisation and Resistance Report (ESPAUR) illustrate:
  • Four in 10 patients with an E.coli bloodstream infection in England cannot be treated with the commonest antibiotic (co-amoxiclav) used in hospitals. In addition, almost one in five of these bacteria were resistant to at least one of five other key antibiotics
  • Of the one million antibiotic resistant bacteria causing urinary tract infections identified in NHS laboratories in 2016, trimethoprim resistance was very common (37%) but the current recommended first line treatment, nitrofurantoin remains effective (3%)
  • Between 2012 and 2016, antibiotic prescribing reduced by 5%, when measured as defined daily doses per 1000 inhabitants per day
  • The number of antibiotic prescriptions dispensed in General Practice fell 13% between 2012 and 2016 (-2% from 2015 to 2016)
  • Dental practices dispensed one in five fewer prescriptions in 2016 compared to 2012 and more than 99% of prescribed antibiotics were in accordance with dental treatment guidelines. 
  • Hospital prescribing has increased year on year, but has reduced use of the last resort antibiotics (piperacillin/tazobactam and carbapenems) by 4% between 2015 and 2016.

Download the repor

  1. Self-care advice provided by the ‘Keep Antibiotics Working’ campaign in leaflets and materials distributed in GP surgeries and pharmacies across England includes:
  2. Ask your pharmacist to recommend medicines to help with symptoms or pain
  3. Get plenty of rest
  4. Drink enough fluids to avoid feeling thirsty
  5. Use paracetamol if you or your child are uncomfortable as a result of fever – which is a sign of the body fighting infection, and normally gets better by itself in most cases
  6. Use tissues for your nose and wash your hands frequently to avoid spreading your infection to family and friends. These symptoms are possible signs of serious illness and should be assessed urgently:

These symptoms are possible signs of serious illness and should be assessed urgently. 

1. If your skin is very cold or has a strange colour, or you develop an unusual rash. 

2. If you feel confused or have slurred speech or are very drowsy.

3. If you have difficulty breathing. Signs can include:

  • breathing quickly
  • turning blue around the lips and the skin below the mouth
  • skin between or above the ribs getting sucked or pulled in with every breath

4. If you develop a severe headache and are sick

5. If you develop chest pain

6. If you have difficulty swallowing or are drooling

7. If you cough up blood

8. If you are feeling a lot worse

If you or your child has any of these symptoms, are getting worse or are sicker than you would expect (even if your/their temperature falls), trust your instincts and seek medical advice urgently from NHS 111 or your GP. If a child under the age of five has any of symptoms 1–3, go to A&E immediately or call 999.

8.   Partners working together in the West Midlands to promote the AMR message are:    PHE West Midlands, NHS CrossCity CCG, Heart of England NHS Foundation Trust (HEFT), Birmingham City Council, and Aston University.

About Aston University: Founded in 1895 and a University since 1966, Aston is a long established research-led university known for its world-class teaching quality, and strong links to business and the professions. Aston University is located in Birmingham and at the heart of a vibrant city and the campus houses all the university’s academic, social and accommodation facilities for our students. Professor Alec Cameron is the Vice Chancellor & Chief Executive. Aston has been a leading university for graduate employment success for over 25 years and our students do extremely well in securing top jobs and careers.  Our strong relationships with industry partners mean we understand the needs of employers, which is why we are also ranked in the top 20 for graduate employability.

[i] Thirty-day all-cause fatality subsequent to MRSA, MSSA and E.coli bacteraemia and C. difficile infection, 2015/16. 2017 at:

[ii] Annual Report of the Chief Medical Officer. Infections and the rise of antimicrobial resistance. Volume Two. 2013. Available at:

[iii] O’Neill, J. Tackling Drug-Resistant Infections Globally: final report and recommendations. 2017. Available at: