New research published in JAMA Pediatrics has found that antimicrobial resistance (AMR) rates increasing “significantly in children over the last two decades, rendering many first-line treatment options ineffective and now increasingly threatening second-line and last-resort options.” CIDRAP has the news.

Researchers found that more than a third of children, in an analysis of over 100,000 bacterial isolates, were resistant to “at least one first-line antibiotic, and roughly one in five were resistant to second-line antibiotics.” AMR is especially high in “ICUs, in the youngest children with the most severe infections, and in resource-limited settings, the study found. But it’s a problem everywhere, and projections indicate it’s likely to get worse in the coming years.”

Of the isolates included in the study, “nearly three-quarters were from hospital wards (47%) and ICUs (27%). The most frequently identified pathogens were Staphylococcus aureus (19%), Klebsiella species (11%), and Escherichia coli (10%).” Resistance was highest (36%) to Access antibiotics, while “22% of the isolates were resistant to Watch antibiotics and 13% to Reserve antibiotics.” Resistance also increased for Watch and Reserve antibiotics over the study period.

The study authors advise that all countries “need to develop antimicrobial stewardship strategies that target the most severe pediatric infections, like sepsis and pneumonia, and reduce unnecessary antibiotic use in people and animals. And more child-friendly antibiotic formulations are needed, so that children get the correct dose in a more palatable format.”