Antibiotics used to treat common infections in infants and children are becoming increasingly ineffective worldwide. But how big a threat is antibiotic resistance really?
A study led by the University of Sydney found that a significant number of antibiotics recommended by the World Health Organization (WHO) for treating childhood illnesses such as pneumonia, sepsis (infections in the bloodstream), and meningitis had an effectivity rate of less than 50 per cent.
This is mainly due to the high rates of antibiotic-resistant strains.
Antibiotic resistance in childhood infections
These results highlighted the need to revise and modernise global recommendations for antibiotic use.
South-East Asia and Pacific regions, including neighbouring Indonesia and the Philippines, are having the most severe impact of the issue, leading to thousands of unnecessary children’s deaths occurring every year due to antibiotic resistance.
The World Health Organization has declared antimicrobial resistance (AMR) as one of the ten global public health challenges faced by humanity.
Worldwide, it is estimated that about three million cases of sepsis occur in newborns every year, resulting in up to 570,000 fatalities, and a significant proportion of these deaths are due to the lack of effective antibiotics for combating resistant bacteria.
Urgent need for updated antibiotic guidelines
This research highlights the urgent need for a comprehensive update of global antibiotic guidelines to coincide with the swiftly evolving rates of antimicrobial resistance (AMR). The most recent guidance from the World Health Organization (WHO) was last published in 2013.
Effective antibiotics
The study identified one antibiotic, ceftriaxone, which is likely effective in treating about one in three cases of sepsis or meningitis in newborns. Ceftriaxone is also extensively used in Australia for managing various infections in children, such as pneumonia and urinary tract infections.
Another antibiotic, gentamicin, was found to have a likelihood of being effective in treating fewer than half of all cases of sepsis and meningitis in children. Gentamicin is frequently prescribed alongside aminopenicillins, which the study demonstrated to have limited effectiveness in combatting bloodstream infections in babies and children.
AMR is more likely to affect children than adults as there is a reduced likelihood of conducting trials for new antibiotics on children and making these antibiotics less accessible to them.
Antibiotic resistance
Dr Williams, Lead author from the University’s School of Public Health and Sydney Infectious Diseases Institute, says the study should be a wake-up call for the world, including Australia.
“Antibiotic resistance is rising more rapidly than we realise. We urgently need new solutions to stop invasive multidrug-resistant infections and the needless deaths of thousands of children each year.
“Antibiotic clinical focus on adults and too often children and newborns are left out. That means we have very limited options and data for new treatments.”
“Antibiotic resistance is rising more rapidly than we realise.”
The study examined 6,648 bacterial isolates from 11 countries across 86 publications to assess the susceptibility of common bacteria responsible for childhood infections to antibiotics.
Potential solutions
Dr Williams emphasised that the most effective approach for addressing antibiotic resistance in childhood infections is to prioritise funding for research into developing new antibiotic treatments specifically tailored for children and newborns.
She is presently investigating the potential use of the older antibiotic, fosfomycin, as a short-term solution for addressing multidrug-resistant urinary tract infections in children within Australia.
She is further collaborating with the World Health Organization’s Paediatric Drug Optimisation Committee to ensure that children can access antibiotics for treating multidrug-resistant infections.
