A global wake-up call: common antibiotics are failing in up to half of all children

    16 March 2016

    The most common antibiotics are failing in up to half of children, a study published in the British Medical Journal has found.

    The researchers, from Bristol University and Imperial College London, reviewed 58 studies from 26 countries involving 78,000 E.coli patients — in particular those with urinary tract infections, which are common in children. In half of the children the bacteria were resistant to ampicillin. In a quarter of the children the bacteria were resistant to trimethoprim, while co-trimoxazole failed in a third of the children.

    The figures were higher still in developing countries. The researchers say that if the trend continues, future treatments could be rendered ineffective.

    The study’s lead author, Ashley Bryce, said: ‘Prevalence of resistance to commonly prescribed antibiotics in primary care in children with urinary tract infections caused by E.coli is high, particularly in countries outside the OECD, where one possible explanation is the availability of antibiotics over the counter.’

    This is one of the first major studies to look at the issue of antibiotic resistance in children, which is important because they are more likely to be prescribed the drugs than other age groups. It was found that resistance is highest in the six months immediately following treatment.

    Dr Ceire Costelloe, study co-lead, said: ‘The results also suggest previous antibiotic use increased the subsequent risk of E.coli resistance to that particular antibiotic — for up to six months after treatment.

    ‘Our findings detail global high-level resistance to some of the most commonly prescribed antibiotics for children in primary care, which could result in several drugs becoming ineffective first-line treatments in many countries.’

    Instant analysis
    This is a significant piece of global research, looking at 80,000 samples, and is a cause for concern on a number of fronts. The first is it confirms that for many children around the world, some of the most commonly prescribed antibiotics used in urinary tract infections in primary care are now no longer effective due to antibiotic resistance.

    This problem appears even greater in countries where antibiotics are available without prescription, further suggesting that over-the-counter antibiotic availability can trigger inappropriate usage and long-term resistance problems.

    A second point is that routine use of antibiotics in early life appears to increase the likelihood that they will not work in adulthood, and another is that up to half of children may now be resistant to some of the most common antibiotics used to treat routine childhood infections. Whereas there has been a very successful drive by GPs in the UK in recent years to reduce the prescribing of antibiotics unless absolutely necessary, globally a great deal of catching up still needs to be done in this area and this involves political will as well as clinical guidelines.

    In the meantime, this study is yet more compelling evidence — if any more were needed — that clinicians must constantly monitor their prescribing of antibiotics so that future generations are not affected by multi-drug resistant bacteria.’

    Research score: 5/5