Three million child deaths linked to drug resistance

More than three million children around the world are thought to have died in 2022 as a result of infections that are resistant to antibiotics, according to a study by two leading experts in child health.

Children in Africa and South East Asia were found to be most at risk.

Antimicrobial resistance – known as AMR – develops when the microbes that cause infections evolve in such a way that antibiotic drugs no longer work.

It has been identified as one of the biggest public health threats facing the world’s population.

A new study now reveals the toll that AMR is taking on children.

Using data from multiple sources, including the World Health Organization (WHO) and the World Bank, the report’s authors have calculated there were more than three million child deaths in 2022 linked to drug-resistant infections.

Experts say this new study highlights a more than tenfold increase in AMR-related infections in children in just three years.

The number could have been made worse by the impact of the Covid pandemic.

Antibiotics are used to treat or prevent a huge range of bacterial infections – everything from skin infections to pneumonia.

They are also sometimes given as a precaution to prevent, rather than treat, an infection – for example if someone is having an operation or receiving chemotherapy treatment for cancer.

Antibiotics have no impact on viral infections, though – illnesses such as the common cold, flu or Covid.

But some bacteria have now evolved resistance to some drugs, due to their overuse and inappropriate use, while the production of new antibiotics – a lengthy and costly process – has slowed right down.

The report’s lead authors, Doctor Yanhong Jessika Hu of Murdoch Children’s Research Institute in Australia and Professor Herb Harwell of the Clinton Health Access Initiative, point to a significant growth in the use of antibiotics that are meant to only be held back for the most serious infections.

Between 2019 and 2021 the use of “watch antibiotics”, drugs with a high risk of resistance, increased by 160% in South East Asia and 126% in Africa.

Over the same period, “reserve antibiotics” – last-resort treatments for severe, multidrug-resistant infections – rose by 45% in South East Asia and 125% in Africa.

The authors warn that if bacteria develop resistance to these antibiotics, there will be few, if any, alternatives for treating multidrug-resistant infections.

Prof Harwell is presenting the findings at the Congress of the European Society of Clinical Microbiology and Infectious Diseases in Vienna later this month.

“AMR is a global problem. It affects everyone. We did this work really to focus on the disproportionate way in which AMR affects children,” he said ahead of the event.

“We estimate three million deaths of children worldwide associated with antimicrobial resistance.”

The WHO describes AMR as one of the most serious global health threats we face, but speaking from Vienna, Prof Harwell warns that there are no easy answers.

“It’s a multi-faceted problem that extends into all aspects of medicine and really, human life,” he said.

“Antibiotics are ubiquitous around us, they end up in our food and the environment and so coming up with a single solution is not easy.”

The best way to avoid a resistant infection is to avoid infection altogether, which means higher levels of immunisation, water sanitation and hygiene are needed, he adds.

“There’s going to be more antibiotics use because there’s more people who need them, but we need to make sure that they are used appropriately and the correct medicines are used.”

Dr Lindsey Edwards, a senior lecturer in microbiology at King’s College London, said the new study “marks a significant and alarming increase compared to previous data”.

“These findings should serve as a wake-up call for global health leaders. Without decisive action, AMR could undermine decades of progress in child health, particularly in the world’s most vulnerable regions.”