Antibiotics for childhood infections losing effectiveness

In a warning for health care professionals a new report says antibiotics used to treat common childhood infections in children and babies are losing their effectiveness in many parts of the world, due to antibiotic resistance.

According to new research, many antibiotics recommended by the World Health Organization (WHO) are less than 50% effectiveness in treating childhood infections such as pneumonia, sepsis (bloodstream infections) and meningitis. 

The new study in The Lancet Regional Health – Southeast Asia has revealed “alarmingly high rates of resistance to commonly prescribed empirical therapies for neonatal and paediatric sepsis and meningitis in the Asia-Pacific region.”

“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, 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.”

For this study, researchers pooled data from 86 papers from 11 countries, to determine the treatment coverage of common regimens.

They found that one antibiotic in particular, ceftriaxone, was likely to be effective in treating only one in three (29%) 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.

Another antibiotic, gentamicin, is only likely to be effective in treating 45% of all sepsis and meningitis cases. Other commonly prescribed antibiotics included in this study were aminopenicillins, non-antipseudomonal third generation cephalosporins, and carbapenems.

Antimicrobial resistance (AMR) is one of the top 10 global public health threats facing humanity and poses a serious problem for children and neonates, who are affected by a high burden of infectious diseases. This is because new antibiotics are less likely to be trialled on, and made available to, children.

This is particularly concerning in South East Asia and the Pacific where healthcare resources and access to newer agents to treat multidrug-resistant pathogens is limited.

Lead author Dr Phoebe Williams from the University of Sydney’s School of Public Health in Australia is an infectious disease specialist whose research focuses on reducing AMR in high-burden healthcare settings in South East Asia.

“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,” she says.

Williams says 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 is on adults and too often children and newborns are left out. That means we have very limited options and data for new treatments.”

Williams is currently looking into an old antibiotic, fosfomycin, as a temporary lifeline to treat multidrug-resistant urinary tract infections in children in Australia.

The researchers also call for the urgent need for updated global antibiotic guidelines to reflect rapidly evolving rates of AMR.

“Whilst we wish to emphasise that our approach is exploratory and amounts to a first approximation, these data call into urgent question the adequacy of coverage currently provided by WHO-recommended first- and second-line antibiotic regimens,” they write.