Antibiotic Blind Spots: Why Kids Are Missing Out on Life-Saving Drugs

Crucial antibiotic treatments capable of combating severe paediatric infections are currently inaccessible, a deficiency attributed to a dearth of comprehensive safety and dosage data, according to recent scholarly investigation.

Two extensive reviews, spearheaded by the Murdoch Children’s Research Institute (MCRI) and the Australasian KIDS DOSE consortium, have illuminated the obstacles encountered by children in Australia, New Zealand, and the Pacific Islands when seeking therapeutic interventions for antimicrobial-resistant (AMR) infections designated as high-priority by the World Health Organization.

The published findings, featured in The Lancet Regional Health – Western Pacific, revealed that out of twelve antibiotics recommended for critical bloodstream infections originating from pathogenic Gram-negative bacteria, merely six held licensing for pediatric patients under twelve years old, and a mere three were approved for infants. Furthermore, standard antibiotic regimens were frequently sub-therapeutic for children below the age of twelve.

AMR represents an escalating global public health crisis, precipitating 1.27 million fatalities annually worldwide, including a significant toll of 250,000 children under the age of five. Within Australia, one in five pediatric infections caused by Gram-negative bacteria exhibits resistance to antibiotics, with infection rates disproportionately affecting Indigenous children.

Associate Professor Amanda Gwee emphasized the imperative for augmented research to rectify considerable disparities in equity and access that impede the provision of appropriate medical care for children.

Our comprehensive analysis uncovered a limited array of treatment modalities available for children afflicted with life-threatening conditions stemming from MRSA (a strain of staphylococcus resistant to multiple antibiotics) and VRE infections (originating from gut bacteria), particularly for those residing in the Pacific Islands.

Associate Professor Amanda Gwee, Murdoch Children’s Research Institute

“The KIDS DOSE network is actively generating evidence to ensure that children, who are most susceptible to severe infections, receive antibiotic dosages that are both safe and efficacious, concurrently providing support to low-resource nations in enhancing their capacity for detecting and monitoring AMR within their communities,” she articulated.

Dr. Gwee further commented that despite the inherent difficulties in obtaining a complete understanding of antimicrobial resistance patterns, the study’s outcomes have been instrumental in pinpointing ongoing research priorities.

“The escalating prevalence of AMR is rendering previously manageable infections untreatable, thereby exacerbating severe morbidity, disability, and mortality, and consequently undermining the efficacy of contemporary medical practices that are reliant on potent antimicrobial agents,” she stated.

“To effectively address this pervasive challenge, a concerted and coordinated effort is necessitated, encompassing the enhancement of AMR surveillance mechanisms, the promotion of additional clinical investigations involving pediatric populations, the removal of restrictive licensing regulations, and the upgrading of laboratory infrastructure and technical proficiencies.”

Associate Professor Gwee indicated that the KIDS DOSE Consortium intends to tackle this issue by initiating trials to evaluate the performance of novel antibiotics against bloodstream, bone, and urinary tract infections in children, thus expediting the availability of more effective therapeutic strategies.