We face a return to the dark ages of life-threatening surgery unless we can preserve the infection-killing powers of antibiotics, according to England’s chief medical officer.

Dame Sally Davies made her remarks as Public Health England (PHE) published a report showing that 3 million common surgical procedures, including caesarean sections and hip replacements, could be hazardous in a future where hospital-acquired infections have become resistant to the antibiotics we have to treat them.

It says bloodstream infections, where bacteria get into the body usually through a wound and can be fatal, rose by 35% between 2013 and 2017. There has been some progress in reducing total antibiotic use, however, which fell by 6.1% between 2014 and 2017 in England.

But PHE is still very worried. The risk of infection in some sorts of surgery without antibiotics is significant. Antibiotics are given to one in three surgical patients either before they are wheeled into the operating theatre or when they are recovering. PHE says that without antibiotics, infections from surgery could double, potentially endangering lives.

Antibiotics have long been losing their bug-killing power, for a number of reasons, including overuse. The report says they are still being given to patients with coughs, earaches and sore throats, which may be viral infections not susceptible to antibiotics and will get better by themselves anyway. PHE says a 2017 survey showed 38% of people still expect an antibiotic from a doctor’s surgery, NHS walk-in centre or GP out-of-hours service when they visit with a cough, flu or a throat, ear, sinus or chest infection.

A new PHE campaign will urge people to accept the advice of their doctor, nurse of other healthcare staff as to when they need antibiotics.

“Antibiotics are an essential part of modern medicine, keeping people safe from infection when they are at their most vulnerable,” said Prof Paul Cosford, medical director of PHE.

“It is concerning that, in the not-too distant future, we may see more cancer patients, mothers who’ve had caesareans and patients who’ve had other surgery facing life-threatening situations if antibiotics fail to ward off infections.

“We need to preserve antibiotics for when we really need them and we are calling on the public to join us in tackling antibiotic resistance by listening to your GP, pharmacist or nurse’s advice and only taking antibiotics when necessary. Taking antibiotics just in case may seem like a harmless act but it can have grave consequences for you and your family’s health in future.”

Davies said the evidence is clear “that without swift action to reduce infections, we are at risk of putting medicine back in the dark ages – to an age where common procedures we take for granted could become too dangerous to perform and treatable conditions become life-threatening.

“The UK has made great efforts in recent years to reduce prescribing rates of antibiotics; however, there continues to be a real need to preserve the drugs we have so that they remain effective for those who really need them and prevent infections emerging in the first place.

“This is not just an issue for doctors and nurses; the public have a huge role to play. Today’s data and the launch of the national Keep Antibiotics Working campaign must be a further wakeup call to us all.”