Alarmingly high rates of bacterial resistance to commonly prescribed antibiotics used to treat children and babies have been found in the Asia-Pacific region in a study led by the University of Sydney.
Specifically, they discovered that many antibiotics recommended by the World Health Organization (WHO) had less than 50% effectiveness in treating childhood infections such as pneumonia, sepsis and meningitis, revealing that global guidelines on antibiotic use were outdated and in desperate need of updates.
Some of the most seriously affected regions were in South-East Asia and the Pacific, including neighbouring Indonesia and the Philippines, where thousands of unnecessary deaths in children resulting from antibiotic resistance occur each year.
The most recent guideline from the WHO was published in 2013 and subsequently the organisation has declared antimicrobial resistance (AMR) one of the top 10 global public health threats facing humanity, highlighting that in newborns, an estimated three million cases of sepsis occur globally each year, with up to 570,000 deaths due largely to a lack of effective antibiotics to treat resistant bacteria.
The study analysed 6,648 bacterial isolates from 11 countries across 86 publications to review antibiotic susceptibility for common bacteria causing childhood infections and the findings, published in the Lancet Southeast Asia, add to mounting evidence that the common bacteria responsible for sepsis and meningitis in children are becoming increasingly resistant to prescribed antibiotics.
One antibiotic in particular, ceftriaxone, which is also widely used in Australia to treat many infections in children, such as pneumonia and urinary tract infections, was likely to be effective in treating only one in three cases of sepsis or meningitis in newborn babies.
Another antibiotic, gentamicin, was found likely to be effective in treating fewer than half of all sepsis and meningitis cases in children. Gentamicin is commonly prescribed alongside aminopenicillins, which the study showed also had low effectiveness in combating bloodstream infections in babies and children.
Lead author, Dr Phoebe Williams, an infectious disease specialist from the University’s School of Public Health, who also works as a clinician in Australia, explained that AMR was more problematic for children than adults, as new antibiotics were less likely to be trialled on, and made available to, children.
Dr Williams said the study should be a wake-up call for the whole world, including Australia.
“We are not immune to this problem – the burden of anti-microbial resistance is on our doorstep – and is rising more rapidly than we realise,” she said.
“We urgently need new solutions to stop invasive multidrug-resistant infections and the needless deaths of thousands of children each year.”
Dr Wiliams said the best way to tackle antibiotic resistance in childhood infections is to make funding to investigate new antibiotic treatments for children and newborns apriority, and she is currently looking into an old antibiotic, Fosfomycin, as a temporary lifeline to treat multidrug-resistant urinary tract infections in children in Australia.
“Antibiotic clinical focus on adults and too often children and newborns are left out an that means we have very limited options and data for new treatments.”
She is also working with the WHO’s Paediatric Drug Optimisation Committee to ensure children have access to antibiotics to treat multidrug-resistant infections as soon as possible, to reduce deaths due to AMR among children.