Even as over 2.3 million newborns die of severe bacterial infections (neonatal sepsis) the world over annually with an increasing number becoming resistant to available antibiotics, not enough is being done to develop effective drugs to save these young lives, leading public health global experts have flagged concerns. They have called for urgent intervention in the sector.
In India too, the situation is dismal as an estimated 60,000 neonates die each year from sepsis caused by bacteria resistant to first-line antibiotics. As per doctors, in Indian neonates, the resistance to first-line antibiotics is nearly 90 per cent, which is an alarming sign.
However, presently, of 40 antibiotics approved for use in adults since 2000, only four have included dosing information for neonates in their labeling.
“The urgent need to prioritize the development of antibiotics specifically for newborns through a global antibiotic development and access network” has been outlined in a paper co-authored by international experts in the field of antimicrobial resistance (AMR).
They include experts from the Global Antibiotic Research & Development Partnership (GARDP), Penta - Child Health Research and St George’s, University of London (SGUL) as well as neonatologists in India and South Africa. The paper is published in the December 2022 Bulletin of the World Health Organisation (WHO).
Over the last decade, AMR has worsened to the point where around 50-70 per cent of common pathogens exhibit a high degree of resistance to available first and second-line antibiotics. Despite substantial progress in medical research and a steep decline in the number of children under the age of five who die of preventable diseases, many problems related to child health remain to be tackled. Severe bacterial infections are one of them, the experts said.
“There is an urgent need to identify high priority antibiotics to understand which ones work best and are safe in children, and then make them available where they are needed,” said Mike Sharland from St George’s, University of London, and member of the Antimicrobial Resistance Programme at Penta - Child Health Research.
“By achieving global consensus, we can streamline the process of antibiotic development, allow for faster access to antibiotics, and reduce the burden of AMR on the vulnerable neonatal population,” added Manica Balasegaram, Executive Director of GARDP.
Carlo Giaquinto, president, Penta Foundation, echoed similar views saying that “by bringing together academic clinical trial networks, international research networks, regulators, donors, government and industry sponsors, these public-private partnerships can leverage their multi-disciplinary expertise and funding to speed up access to antibiotics and facilitate the update and routine implementation of global treatment guidelines.” In fact, GARDP, Penta – Child Health Research, SGUL, and other partners have collaborated on a recent global observational study of 3,200 babies with neonatal sepsis across 19 hospitals in 11 countries.
It is evaluating potentially more effective neonatal treatment regimens to overcome resistance to current treatments, especially in low- and middle-income countries, where multidrug-resistant organisms are more prevalent.
“We need to move fast to develop guidelines and protocols on the use of antibiotics, as well as develop new antibiotics,” said SithembisoVelaphi, Head of Paediatrics at the Chris Hani Baragwanath Academic Hospital in Soweto, South Africa.
The paper was co-authored by scientists including Phoebe Williams, School of Public Health at the University of Sydney, Australia; Shamim A Qazi, Department of Maternal, Newborn, Child, and Adolescent Health, WHO and Ramesh Agarwal, Department of Paediatrics, All India Institute of Medical Sciences, India among other.