One of the many challenges faced throughout healthcare today is the management of antimicrobial resistance (AMR). The term refers to the emergence of pathogens that no longer respond to antibiotics, antifungals, antivirals, and antiparasitics, creating genuine concerns about the efficacy of treatment across a broad spectrum of health conditions. The problem requires a collective response from professionals in dental, medical, agricultural, food, and many other industries, as well as the general public.
A growing problem
AMR occurs naturally, as pathogens evolve to overcome the effects of antibiotics over time, rendering medications useless against various illnesses. However, the issue is being accelerated by a number of human behaviours, like misuse of antibiotics. Improper use or overconsumption of related medications in human and animal sectors is providing an opportunity for pathogens to adapt more quickly than they otherwise would. This, combined with environmental, social, medicinal, health, climatic, and economic factors, is driving the emergence of new resistant pathogens.[i]
Consequently, AMR has become a major threat to public health around the globe, contributing to an estimated 35,200 deaths every year in the UK alone.[ii] In 2023, approximately 66,720 serious antibiotic resistant infections were recorded across the nation,[iii] representing a 7% increase from 62,300 in 2019.
The same government report found that one of the main causes of antibiotic resistant bloodstream infections was E. coli; responsible for around 65% of related infections in 2018-23.
Worryingly, the research also identified a widening gap between those living in the most and least deprived areas of society with regards to the risk of acquiring an antibiotic resistant infection. In fact, people living in the former regions in 2023 were more than 42% more likely to experience an antibiotic resistant infection – which represented a significant rise from 30% in 2019. This adds to the already stark data showing that those living in the 20% most deprived areas of England are twice as likely to be admitted to hospital than those from the least deprived locations.[iv]
A nationwide mandate
The big concern about AMR is that infections which have been easily treatable for decades will become incurable, putting millions of people worldwide at significant health risks. In 2019, the UK government published “The UK’s 20-year vision for antimicrobial resistance”,[v] which aims to guide a collaborative effort across the nation to effectively contain, control, and mitigate the development of further AMR. It lays out a plan to reduce the burden of infection on the NHS, to encourage optimal use of antimicrobials, and to support new diagnostics, therapies, and vaccines to facilitate infection prevention across the board. It suggests that at least 20% of all antibiotic prescriptions in primary care are inappropriate, which highlights a key area that we as healthcare professionals should take note of.
To make change more manageable, the government created four 5-year action plans to guide the two-decade mandate. “Confronting antimicrobial resistance 2024 to 2029”[vi] is focused on four key themes: reducing the need for, and unintentional exposure to, antimicrobials; optimising the use of antimicrobials; investing in innovation, supply, and access; and being a good global partner. Of relevance to dental professionals is the spotlight on antimicrobial stewardship and disposal, promoting appropriate prescription and use of medications.
The dental contribution
These are crucial aspects of the dental professional’s role today. We should all carefully consider when and why we prescribe antimicrobials to our patients. They remain an important adjunctive therapy to prevent or treat oral infection, but we have a responsibility to use them only when clinically indicated. The Faculty of General Dental Practice and Faculty of Dental Surgery have produced a useful document[vii] that outlines current research in the field and offers authoritative guidance to aid clinicians’ decision-making. It summarises the evidence for antimicrobial use in various situations, from endodontics to periodontology, chronic infections, dry socket, prophylaxis, and more.
Also within our remit is patient education on the topic. Research suggests that some confusion remains among the general public with regards to the morality of antimicrobial consumption when not required. There is also a lack of understanding about how personal actions contribute to the broader AMR challenge.[viii] The complex nature of the issue means that educating patients can be difficult in itself,[ix] but it is important that we try. Building rapport with patients is beneficial,[x] as is the use of specially designed toolkits, such as those provided by the UK government.[xi]
Time for action
Ultimately, it is for everyone to take action against antimicrobial resistance if we are to successfully protect the future health of the global population. It begins with small steps taken by individuals, which centre around appropriate use of the drugs.
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Author: Michael Sultan
[i] Ye Z, Li M, Jing Y, Liu K, Wu Y, Peng Z. What Are the Drivers Triggering Antimicrobial Resistance Emergence and Spread? Outlook from a One Health Perspective. Antibiotics (Basel). 2025 May 26;14(6):543. doi: 10.3390/antibiotics14060543. PMID: 40558133; PMCID: PMC12189934.
[ii] Antimicrobial resistance: addressing the risks. Thirtieth report of session 2024-25. UK Parliament. June 2025. https://publications.parliament.uk/pa/cm5901/cmselect/cmpubacc/646/report.html [Accessed February 2026]
[iii] Antibiotic resistant infections continue to rise. UK Health Security Agency. 14 November 2024. Gov.uk. https://www.gov.uk/government/news/antibiotic-resistant-infections-continue-to-rise [Accessed February 2026]
[iv] Health inequalities in health protection report 2025. Research and analysis. UK Health Security Agency. May 2025. https://www.gov.uk/government/publications/health-inequalities-in-health-protection-report/health-inequalities-in-health-protection-report-2025 [Accessed February 2026]
[v] Contained and controlled. The UK’s 20-year vision for antimicrobial resistance. HM Government. January 2019. https://www.gov.uk/government/publications/uk-20-year-vision-for-antimicrobial-resistance [Accessed February 2026]
[vi] Confronting antimicrobial resistance 2024 to 2029. Policy paper. Department of health & Social Care. Scottish Government. Welsh Government. Department for Environment, Food & Rural Affairs, Department of Health (Northern Ireland). Department of Agriculture, Environment and Rural Affairs (Northern Ireland). May 2024. https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029/confronting-antimicrobial-resistance-2024-to-2029 [Accessed February 2026]
[vii] Antimicrobial prescribing in dentistry. Good practice guidelines. 3rd edition. https://www.rcseng.ac.uk/-/media/files/rcs/fds/publications/fds-amp-2020.pdf [Accessed February 2026]
[viii] Gosha Colquhoun, Janyne Afseth, Ross Fagan, Fiona Thomson, Nicola Ring, Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography, JAC-Antimicrobial Resistance, Volume 6, Issue 4, August 2024, dlae117, https://doi.org/10.1093/jacamr/dlae117
[ix] Balea LB, Gulestø RJA, Xu H, Glasdam S. Physicians’, pharmacists’, and nurses’ education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review. Front Antibiot. 2025 Jan 9;3:1507868. doi: 10.3389/frabi.2024.1507868. PMID: 39850331; PMCID: PMC11754411.
[x] Martin SJ, Chadwick S, Bakhit M, Frost KJ, Hawksworth G, Aldeyab MA. Exploring antimicrobial stewardship education and training support for community pharmacists in the United Kingdom. J Pharm Policy Pract. 2024 Jun 28;17(1):2365224. doi: 10.1080/20523211.2024.2365224. PMID: 38952488; PMCID: PMC11216260.
[xi] Raising awareness about AMR: toolkits for healthcare professionals. UK Health Security Agency. November 2022. https://ukhsa.blog.gov.uk/2022/11/17/raising-awareness-about-amr-toolkits-for-healthcare-professionals/ [Accessed February 2026]
