Antibiotic resistance in children is rising globally and will worsen over the next decade, according to a world-first monitoring platform.
The findings, led by Murdoch Children’s Research Institute (MCRI) in collaboration with the University of Sydney, Clinton Health Access Initiative (CHAI) and The Chinese University of Hong Kong, analyzed more than 106,000 infection samples from children across 82 countries, discovering that antibiotic resistance increased in every region between 2004 and 2022. Babies and children in intensive care and countries with fewer healthcare resources were the most affected.
Published in JAMA Pediatrics, the research found two types of Gram-negative bacteria are driving antimicrobial resistance globally. Acinetobacter baumannii, which commonly causes hospital-acquired bloodstream infections and pneumonia, showed the highest overall resistance. Klebsiella, causing urinary tract infections and liver abscesses, recorded the fastest increase, particularly in Southeast Asia, Eastern Europe and the Western Pacific.
Resistance to last‑line carbapenem antibiotics is projected to rise substantially by 2035, reaching 82 percent and 35 percent, for each superbug, respectively.
Additionally, forecast modeling suggests that by 2035, some of the most dangerous pathogens could become highly resistant to last‑line treatments.
The newly launched AMR in Kids website, created by the study team, allows clinicians, researchers and policymakers to explore antibiotic resistance by country, bacteria and antibiotic class. It also provides region and pathogen-specific forecasts to 2035, helping researchers to identify emerging threats, inform treatment decisions and help guide public health planning.
MCRI and University of Sydney Yanhong Jessika Hu said by combining almost two decades of global data with forecasting, the platform could identify where resistance was likely to emerge before it becomes an even greater clinical challenge.
Despite facing unique treatment challenges, children have been overlooked in global antibiotic resistance surveillance. She said more action is needed, especially measures specifically targeted toward children, according to MCRI associate professor Penelope Bryant.
“In low-income countries we need to address unregulated antibiotic use and poor sanitation,” she said. “These countries need better access to diagnostic techniques and first-line antibiotics. In high-income countries, antibiotic overuse must be tackled across farming, veterinary, primary care and hospital settings, while infection control remains critical. We also need child-friendly antibiotic formulations, clearer dosing guidance and funding for trials on safely reducing antibiotic use.”
Data from Murdoch Children’s Research Institute