High rates of childhood antibiotic resistance

High rates of childhood antibiotic resistance
High rates of childhood antibiotic resistance
Medicines to treat common infections in children and babies are no longer effective in much of the world due to high rates of antibiotic resistance, according to a study led by the University of Sydney which has found that many antibiotics recommended by the World Health Organization (WHO) were less than 50 percent effective in treating childhood infections such as pneumonia, sepsis (bloodstream infections) and meningitis. The findings, published in The Lancet Regional Health, add to growing evidence that common bacteria responsible for sepsis and meningitis in children are often resistant to prescribed antibiotics and show that global guidelines on their use of antibiotics are outdated and need updating.

The most severely affected regions are in Southeast Asia and the Pacific, including neighboring Indonesia and the Philippines, where thousands of unnecessary child deaths occur each year as a result of antibiotic resistance. The WHO has declared that antimicrobial resistance It is one of the top 10 global threats for the public health facing humanity. It is estimated that around three million cases of sepsis in newborns occur worldwide each year, with up to 570,000 deaths: many of these are due to the lack of effective antibiotics to treat resistant bacteria.

Antibiotics with more resistance

The study has found that one antibiotic in particular, ceftriaxone, is likely to be effective in treating only one in three cases of sepsis or meningitis in newborn babies. Ceftriaxone is also widely used in Australia to treat many infections in children, such as pneumonia and urinary tract infections. Additionally, another antibiotic, gentamicin, has been found to probably be effective in treating less than half of all cases of sepsis and meningitis in children. Gentamicin is commonly prescribed along with aminopenicillins, which the study also shows have low effectiveness in fighting bloodstream infections in infants and children. Lead author Dr. Phoebe Williams, of the University’s School of Public Health and the Institute of Sydney Infectious Diseases, is an infectious disease specialist whose research focuses on reducing antimicrobial resistance in high-burden healthcare settings in Southeast Asia. Antimicrobial resistance is more problematic for children than adults, as new antibiotics are less likely to be tested and made available to children. ‘We are not immune to this problem: the burden of antimicrobial resistance is at our doorstep,’ she says. ‘Antibiotic resistance is increasing faster than we think. We urgently need new solutions to stop invasive multidrug-resistant infections and the unnecessary deaths of thousands of children each year,’ warns Dr Williams.

Study results

The study analyzed 6,648 bacterial isolates from 11 countries in 86 publications to review the antibiotic susceptibility of common bacteria that cause childhood infections. Dr Williams explains that ‘the best way to tackle antibiotic resistance in childhood infections is prioritize funding to research new antibiotic treatments for children and newborns‘. ‘The antibiotic clinic focuses on adults and, too often, children and newborns are excluded. That means we have very limited options and data for new treatments,’ he notes. Dr Williams is currently investigating an older antibiotic, fosfomycin, as a temporary lifeline to treat multidrug-resistant urinary tract infections in children in Australia. He is also working with WHO Pediatric Medicines Optimization Committee to ensure that children have access to antibiotics to treat multidrug-resistant infections as soon as possible, to reduce deaths from antibiotic resistance among children. ‘This study reveals important issues related to the availability of effective antibiotics to treat serious infections in children,’ says senior author and director of the Cambodia Oxford Medical Research Unit at Angkor Children’s Hospital, Siem Reap and professor of pediatric microbiology at the University of Oxford, Paul Turner.

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