Supply of antimicrobial most common outcome for Pharmacy First consultations
Patrick Grice,
18 Nov 2025
1 Min
Supply of antimicrobial most common outcome for Pharmacy First consultations
Patrick Grice,
18 Nov 20251 Min
In Health & NHS
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With the publication of the English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) Report 2024 to 2025 , for the first time national data is available linking the supply of antimicrobials with the seven common infections included under the Pharmacy First Scheme in England.
For the 12 months from April 2024 to March 2025 a total of 2,339,908 consultations were delivered in English community pharmacies to 2,252,359 patients for the seven infection pathways.
A supply of an antimicrobial or antimicrobial-sparing medicine (where applicable), were the most common outcomes and varied by infection pathway (see table below)
Face-to-face consultations accounted for 97 per cent or greater for all infection pathways, with all acute otitis media consultations required to occur face-to face.
Children aged 0 to 14 years had 490,576 consultations, accounting for 21 per cent of all consultations, with little variation by gender, supporting the importance of this cohort for targeted stewardship interventions, says the report.
Females accounted for 64 per cent of consultations for the five infection pathways that adults of both genders were able to access, signalling potential gender differences in incidence of infection or health-seeking behaviour, the report notes.
Each infection pathway has a defined population eligible to access care, and the population rate of access (number of people consulting out of the population within scope for the infection pathway) was greatest for uncomplicated UTI, followed by acute otitis media and then acute sore throat.
From a service level perspective, the largest number of consultations was for acute sore throat (n = 754,402), and the smallest number of consultations was for shingles (n = 57,523).
The number of consultations varied by month for 6 of the 7 infection pathways, reflecting seasonal variations associated with the type of infections. Infected insect bites reported the largest seasonal variation with 67 per cent of consultations occurring between June and September 2024.
The infection pathways with the largest rate of urgent referrals were uncomplicated urinary tract infection (4 per cent of consultations) and shingles (4 per cent of consultations) followed by acute otitis media (2 per cent of consultations).
Population insights from the Antimicrobial Stewardship – Pharmacy First dashboard
| Pharmacy First Pathway |
No of consultations April 24 - March 25 Total = 2,339,908 |
No of patients April 24 - March 25 Total = 2,252,359 |
Percentage of consultations with: Advice only |
Antimicrobial |
Antimicrobial |
| Acute otitis media (children aged 1 to 17 years) | 269,308 (11.5% |
259,316 (11.5%) |
19% | 45% | 30% |
| Acute sinusitis (adults and children 12 years and over) |
278,684 (11.9%) |
266,445 (11.8%) |
13% | 47% | 36% |
| Acute sore throat (adults and children 5 years and over | 806,491 (34.5%) |
774,092 (34.4%) |
29% | 65% | None available |
| Impetigo (non-bullous for adults and children one year and over) | 99,223 (4.2%) |
95,653 (4.2%) |
4% | 68% | 25% |
| Infected insect bites (adults and children one year and over) | 200,023 (8.5%) |
195,299 (8.7%) |
13% | 83% | None available |
| Shingles (for adults 18 years and over) | 59,684 (2.6%) |
58,628 (2.6%) |
10% | 82% | None available |
| Uncomplicated UTI (for women 16 - 64 years with suspected lower UTI) |
626,495 (26.8%) |
604,926 (26.9%) |
7% | 85% | None available |
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