Antibiotic prescribing fell sharply during the pandemic as a result of changes in healthcare provision and public behaviour, as well as greater understanding of differences between viral and bacterial infections, according to a new report.

Analysis from Antimicrobial Resistance and Health Associated Infection (ARHAI) Scotland shows use of antibiotics in humans has decreased by 17.1% in the last five years.

Antibiotic prescriptions fell by 11.8% between 2019 and 2020.

The organisation says people’s increased abilities to practice self-care for minor infections, improved hand hygiene, and desire to protect the NHS ‘may have contributed’.

Intensive covid-19 media coverage has allowed the public to better understand the differences between viral and bacterial infections, which has also likely played a part in reduced antibiotic use.

ARHAI says these changes must be built upon in ongoing efforts to tackle the major global health issue of antibiotic resistance.

Described as a ‘slow burning pandemic’, antibiotic resistance is thought to lead to 700,000 deaths a year globally and 12,000 in the UK – the same number from breast cancer.

Clinicians have been encouraged to avoid unnecessary prescriptions to try to slow the development of resistance and preserve currently available antibiotics.

The findings show those prescribing in primary care – where just under 85% of antibiotics are prescribed – followed good practice throughout the pandemic to optimise antibiotic use.

When there is clinical need for antibiotics, prescribing only for the recommended duration and avoiding use of broad spectrum antibiotics are ways clinicians can reduce risk of resistance.

Drugs companies are paid by volume of antibiotics sold, which makes developing new types unattractive due to high costs and low returns.

A subscription type model, where the NHS pays pharmaceutical companies up-front for access to antibiotics, rather than reimbursing them based on quantity sold, is being trialled in England.

Scotland’s medicines gatekeeper, the Scottish Medicines Consortium (SMC), is acting as a formal observer of the pilot, which is expected to be completed early next year.

It is hoped, in time, such incentives for manufacturers will strengthen the global antibiotic pipeline.

Read more: Dentists’ key role in reducing antibiotics; SMC backs antimicrobials pilot; Hospital infections costing Scotland millions

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