ANTIBIOTIC RESISTANCE IN CHILDREN: A GROWING GLOBAL HEALTH CONCERN

Abstract — Every antibiotic prescribed to a child writes two stories at once: the first isthe infection that is cured, and the second is the quiet selection of bacteria that survive thedrug. This article examines how that second story has become a global paediatricemergency. Drawing on recent international surveillance reports, a multinational neonatalsepsis cohort and a hospital prescribing survey, it traces the burden of drug-resistantinfection in infants and children, identifies the pathogens and resistance mechanismsbehind it, and asks why standard treatment regimens are faltering in the settings that needthem most. A central paradox emerges: although deaths directly attributable to resistantinfection in children under five have fallen by almost 60% since 1990, resistant bacterianow account for a larger share of the infectious deaths that remain. Regimensrecommended for neonatal sepsis and meningitis are estimated to cover fewer than half ofcases in parts of Southeast Asia and the Pacific, and prescribing patterns differ widelybetween countries. The article closes with a layered framework of prevention, diagnosis,prescribing, surveillance and innovation through which paediatric resistance can becontained. Keywords: Antibiotic resistance, children, neonatal sepsis, antimicrobial stewardship,AWaRe classification, multidrug-resistant bacteria, global health.