Health Australia (Commonwealth Union) – The Asia-Pacific region has witnessed alarming rates of bacterial resistance to commonly prescribed antibiotics used to treat infants and children. Antibiotics, once effective in combating common infections in the pediatric population, are losing their efficacy on a global scale due to the soaring levels of antibiotic resistance.
A study led by the University of Sydney has unveiled that numerous antibiotics recommended by the World Health Organization (WHO) exhibit less than 50 percent effectiveness in treating childhood infections like pneumonia, sepsis (bloodstream infections), and meningitis. These findings underscore the urgent need to revise and update global antibiotic guidelines, as current recommendations are outdated.
The most severely affected regions are in South-East Asia and the Pacific, including neighboring countries like Indonesia and the Philippines, where thousands of needless child deaths occur annually due to antibiotic resistance.
Antimicrobial resistance (AMR) has been identified by the WHO as one of the top 10 global public health threats. In newborns, an estimated three million cases of sepsis occur worldwide each year, resulting in up to 570,000 deaths, with a significant portion attributed to the lack of effective antibiotics to combat resistant bacteria.
This research, published in Lancet South East Asia, reinforces the mounting evidence that common bacteria responsible for sepsis and meningitis in children have become frequently resistant to prescribed antibiotics. It underscores the pressing need to update global antibiotic guidelines to align with the rapidly evolving rates of AMR. The most recent WHO guideline on this matter dates back to 2013.
The study highlights the worrying fact that one antibiotic, ceftriaxone, is likely to be effective in treating only one in three cases of sepsis or meningitis in newborns. Ceftriaxone is also widely used in Australia to treat various infections in children, such as pneumonia and urinary tract infections. Additionally, another antibiotic, gentamicin, was found to be likely effective in treating less than half of all sepsis and meningitis cases in children. This antibiotic is frequently prescribed in conjunction with aminopenicillins, which the study demonstrates also have limited effectiveness in combatting bloodstream infections in infants and children.
Dr. Phoebe Williams, the lead author from the University’s School of Public Health, is an infectious disease specialist whose research centers on reducing AMR in high-burden healthcare settings in Southeast Asia. She serves as a clinician in Australia and notes the increasing incidence of multidrug-resistant bacterial infections in children worldwide.
Notably, AMR poses a more significant challenge for children than adults, as new antibiotics are less likely to be tested on and made available for pediatric use. Dr. Williams underscores that this study should serve as a wake-up call for the global community, including Australia.
“We are not immune to this problem – the burden of anti-microbial resistance is on our doorstep,” added Dr. Williams.
“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 research scrutinized 6,648 bacterial isolates from 11 countries encompassed in 86 publications to assess antibiotic susceptibility concerning prevalent bacteria responsible for childhood infections.
Dr. Williams emphasized that the most effective strategy for addressing antibiotic resistance in childhood infections lies in prioritizing funding for the exploration of novel antibiotic treatments specifically designed for children and infants.
“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 presently investigating the use of an older antibiotic, fosfomycin, as a stopgap solution to address multidrug-resistant urinary tract infections in children within Australia.
Additionally, she is collaborating with the WHO’s Paediatric Drug Optimisation Committee to expedite access for children to antibiotics capable of combating multidrug-resistant infections. This collaborative effort aims to swiftly reduce fatalities stemming from antimicrobial resistance (AMR) in the pediatric population.
