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, said Dr Phoebe Williams
Published Date – 05:48 PM, Tue – 31 October 23
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Washington DC: A study has found that due to high rates of antibiotic resistance, drugs used to treat common infections in children and babies are no longer effective in significant regions of the world.
Many antibiotics recommended by the World Health Organisation (WHO) showed less than 50% efficiency in treating childhood diseases such as pneumonia, sepsis (bloodstream infections), and meningitis, according to a study headed by the University of Sydney. The findings reveal that global antibiotic guidelines are out of date and need to be updated.
The most severely affected places are in Southeast Asia and the Pacific, particularly near Indonesia and the Philippines, where antibiotic resistance causes thousands of avoidable deaths in children each year.
Antimicrobial resistance (AMR) has been identified by the WHO as one of the top ten global public health risks facing humanity. Each year, an estimated three million episodes of sepsis in infants occur worldwide, with up to 570,000 deaths; many of these are caused by a lack of effective antibiotics to treat resistant bacteria.
The findings, published in the journal Lancet South East Asia, added to accumulating evidence that common bacteria causing sepsis and meningitis in children are frequently resistant to medications.
The study discovered that one antibiotic in particular, ceftriaxone, was likely to be helpful in treating only one out of every three instances of infant sepsis or meningitis. Ceftriaxone is also frequently used in Australia to treat a variety of paediatric diseases, including pneumonia and urinary tract infections.
Gentamicin, another antibiotic, was shown to be likely successful in treating less than half of all sepsis and meningitis cases in children.
Gentamicin is routinely used in conjunction with aminopenicillins, which the study found to be ineffective in treating bloodstream infections in newborns and children.
Dr Phoebe Williams of the University of Sydney’s School of Public Health and the Sydney Infectious Diseases Institute is an infectious disease specialist whose research focuses on lowering AMR in high-burden healthcare settings in Southeast Asia.
She is also a clinician in Australia. According to Dr. Williams, multidrug-resistant bacterial illnesses in children are becoming more common around the world.
Children are more vulnerable to AMR than adults because new antibiotics are less likely to be tested on and made available to them.
According to Dr. Williams, the study should serve as a wake-up call for the entire world, including Australia.
“We are not immune to this problem – the burden of anti-microbial resistance is on our doorstep,” she said.
“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.” The study analysed 6,648 bacterial isolates from 11 countries across 86 publications to review antibiotic susceptibility for common bacteria causing childhood infections.
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 a priority.
“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.” Dr Williams is currently looking into an old antibiotic, fosfomycin, as a temporary lifeline to treat multidrug-resistant urinary tract infections in children in Australia.
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.
“This study reveals important problems regarding the availability of effective antibiotics to treat serious infections in children,” says senior author Paul Turner, director of the Cambodia Oxford Medical Research Unit at Angkor Hospital for Children, Siem Reap and professor of paediatric microbiology at the University of Oxford, UK.
“It also highlights the ongoing need for high-quality laboratory data to monitor the AMR situation, which will facilitate timely changes to be made to treatment guidelines.”
