A recent report published in The Lancet Regional Health–Southeast Asia from previously published studies found high levels of resistance to the antibiotics commonly used for empirical treatment of sepsis and meningitis in babies and children in the Asia-Pacific region.1
Researchers from the University of Sydney in Australia conducted this study to guide the empiric treatment of sepsis and meningitis in low and middle-income countries in the Asia-Pacific region. This is an area of the world where babies and children are especially vulnerable to bacterial infections and antibiotic resistance. In an ideal situation where blood culture testing is available, children would be treated with targeted antibiotic therapy; however, such tests are very rare to find in these countries.2
The review of 86 studies found that many of the World Health Organization’s (WHO) recommended antibiotics for sepsis and meningitis in newborns in 11 countries in Southeast Asia and the Pacific were less than 50 percent effective and many were also than 30 percent effective.3
Another report published in 2022 by Global Antibiotic Research & Development Partnership (GARDP) stated that hospitals in the 11 countries in Southeast Asia and the Pacific were less likely to use the WHO’s guidance on first- and second- line antibiotic treatments as a result of antibiotic resistance. Those hospitals were more likely to use last resort antibiotics such as carbapenems.4 5
Antibiotics Found Less Effective at Treating Sepsis and Meningitis in Newborns
The 2023 report evaluated the commonly recommended and prescribed antibiotics to treat sepsis and meningitis in children in Southeast Asia and the Pacific, which included ampicillin, gentamicin, non-antipseudomonal third generation cephalosporins (ceftriaxone, cefotaxime) and carbapenems.6
The review found that ceftriaxone, an antibiotic also used in Australia to treat pneumonia and urinary tract infections in children, was only likely to be effective in treating one in three cases of sepsis and meningitis in newborns. The antibiotic gentamicin was also found to be ineffective in treating fewer than half of all sepsis and meningitis cases in children.7
The lead researcher of the study, Dr. Phoebe Williams, stated:
We are not immune to this problem—the burden of anti-microbial resistance is on our doorstep. Antibiotic resistance is rising more rapidly than we realize. We urgently need new solutions to stop invasive multidrug-resistant infections and the needless deaths of thousands of children each year.8
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1 William P. et. al. Coverage gaps in empiric antibiotic regimens used to treat serious bacterial infections in neonates and children in Southeast Asia and the Pacific. The Lancet Regional Health–Southeast Asia Oct. 31, 2023.
2 Dall C. Study raises questions about efficacy of antibiotics for serious childhood infections. Center for Infectious Disease Research and Policy Oct. 31, 2023.
5 Global Antibiotic Research & Development Partnership. GARDP Neonatal Sepsis Study Report 2022.
6 William P. et. al. Coverage gaps in empiric antibiotic regimens used to treat serious bacterial infections in neonates and children in Southeast Asia and the Pacific. The Lancet Regional Health–Southeast Asia Oct. 31, 2023.
7 Ramsey L. Antibiotics no longer effective in treating childhood infections in large parts of the world. News Medical –Life Sciences Oct. 31, 2023.