Life-saving antibiotics that could treat severe infections in babies and children aren't accessible due to a lack of data around safety and dosage, new research shows.
Two wide sweeping reviews, led by Murdoch Children's Research Institute (MCRI) and the Australasian KIDS DOSE consortium , have discovered the barriers children are experiencing in Australia, New Zealand and the Pacific Islands when accessing treatment for the antimicrobial resistant (AMR) infections deemed the highest priority by the World Health Organization.
The findings, published in The Lancet Regional Health - Western Pacific , found of the 12 antibiotics recommended for serious bloodstream infections caused by a harmful bacteria, Gram-negative bacteria, only six were licensed in children aged under 12 and just three in babies. Standard antibiotic doses were also often too low for children under 12 years.
AMR is a growing public health problem, causing 1.27 million deaths globally every year, including 250,000 children under five years old. In Australia, one in five childhood infections caused by Gram-negative bacteria is antibiotic resistant with rates of infection much higher among First Nations children.
Associate Professor Amanda Gwee said more research was required to address significant equity and access gaps that prevent appropriate treatment for children.
"Our review found limited treatment options for children who have life-threatening illnesses caused by MRSA (a drug-resistant staph infection) and VRE infections (caused by bacteria in the gut), especially those in the Pacific Islands," she said.
"The KIDS DOSE network is building evidence to ensure children, the most vulnerable to serious infections, receive safe, effective antibiotic doses while supporting low resource countries to better detect and monitor AMR in their communities," she said.
Associate Professor Gwee said while it had been challenging to get a full picture of antimicrobial resistance, the findings helped identify ongoing research priorities.
"The increase in AMR is making common infections untreatable, increasing severe illness, disability and death, and undermining modern medicine that relies on effective antimicrobials," she said.
"To confront the challenge, we need coordinated action that improves AMR surveillance systems, supports more clinical trials involving children, removes licensing restrictions and upgrades laboratory infrastructure and technical expertise."
Associate Professor Gwee said the KIDS DOSE Consortium would address the issue by trialling how newer antibiotics perform against bloodstream, bone and urinary tract infections in children, accelerating more effective treatments.
Publication: Daniel Yeoh, Alison Boast, Sophie Wen, Phoebe Williams, Lesley Voss, Brett Ritchie, Mona Mostaghim, Flora Lutui, Alice Lei, Tony Lai, Adam Irwin, Kiera Harwood, Thomas Ewin, Celia Cooper, Emma Best, Sarah Bannister and Amanda Gwee. 'Drug-resistant gram-negative bacterial infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data, and key evidence gaps,' Lancet Regional Health - Western Pacific. DOI: 10.1016/101735
Publication: Amanda Gwee, Sarah Bannister, Emma Best, Jeremy Carr, Kiera Harwood,Tony Lai, Alice Lei, Flora Lutui, Brendan McMullan, Mona Mostaghim, Lesley Voss, Heather Weerdenburg, Phoebe Williams, Amanda Wilkins, and Daniel Yeoh. 'Methicillin-resistant Staphylococcus aureus and vancomycinresistant Enterococcus faecium infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data and key evidence gaps,' Lancet Regional Health - Western Pacific. DOI: 10.1016/101754
*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.
