Antibiotic resistance in children is a growing concern, with a recent global study revealing alarming trends. The research, led by the Murdoch Children’s Research Institute (MCRI) and the University of Sydney, analyzed 106,581 infection samples from children aged up to 18 years across 82 countries, finding that antibiotic resistance increased in every region between 2004 and 2022. This trend is particularly concerning for vulnerable populations, such as babies in intensive care and children in low-income countries, where healthcare resources are limited.
The study identified two bacteria, Acinetobacter baumannii and Klebsiella, as major contributors to the rise in antibiotic resistance. Acinetobacter baumannii, known for its tough double-membrane, has the highest level of drug resistance, while Klebsiella, a common cause of urinary tract infections and liver abscesses, is showing the fastest increase in resistance, especially in southeast Asia, eastern Europe, and the western Pacific. The researchers projected that resistance to last-line antibiotics will reach 82% and 35% for Acinetobacter baumannii and Klebsiella, respectively, by 2035.
This alarming trend is not only affecting severe diseases but also more simple, uncomplicated infections in children, as noted by MCRI associate professor Penelope Bryant. The lack of child-friendly antibiotic formulations and clear dosing guidelines, coupled with the reluctance to run trials on children and the lower profitability of developing treatments for them, exacerbates the problem. Children are particularly vulnerable due to their high rates of bacterial infections and limited antibiotic options.
To address this issue, Bryant and her colleagues launched the AMR in Kids website, providing region and pathogen-specific forecasts to 2035. This resource aims to help identify emerging threats, inform treatment decisions, and guide planning and research. The study and website have been praised by Prof Chris Blyth, the incoming president of the Australasian Society for Infectious Diseases, as "really important work" that highlights the global disparity in antibiotic resistance.
In low-income countries, antibiotic resistance is driven by unregulated antibiotic use and poor sanitation, making better access to diagnostic techniques and first-line antibiotics a priority. In contrast, high-income countries face antibiotic overuse in farming, veterinarian care, and healthcare, which is fueling drug resistance. Treatments for resistant infections in children are rare in high-income countries, but in low-income countries, drug-resistant infections are a leading cause of death in children under five.
The World Health Organization’s classification of antibiotics into three groups—access, watch, and reserve—emphasizes the need for global surveillance systems to track and identify resistance. As noted by Blyth, the challenge is not only the increasing resistance but also the limited treatment options available, leading to the use of more difficult-to-get, expensive, and potentially toxic drugs. The Booth family, whose son Harry has been battling antibiotic-resistant infections, hopes that resources like the AMR in Kids website will help protect children like him.
Despite the growing awareness of the long-term effects of antibiotics, as noted by Eileen Booth, there is still a long way to go in educating the public about antibiotic resistance. The study and the AMR in Kids website are crucial steps in addressing this global health crisis, but much more needs to be done to ensure that children around the world are protected from the devastating impact of antibiotic resistance.
