Study: Over 3 million children died from drug-resistant infections in 2022

Study: Over 3 million children died from drug-resistant infections in 2022

A landmark study presented today at ESCMID Global 2025 found that over 3 million children worldwide will have lost their lives in 2022 due to antimicrobial resistance (AMR) infections.

The study highlights the urgent need for regional and global strategies to control pediatric AMR, particularly in high-risk areas such as Southeast Asia and Africa. AMR poses a critical threat to children, who are highly vulnerable to infections. Access to new antibiotic formulations is often much more limited for children due to delays in product development.

The study data found that more than 752,000 children in Southeast Asia and 659,000 children in Africa died from AMR-related complications in 2022 alone. Many of these deaths were associated with the use of watch antibiotics (drugs with a high risk of resistance) and reserve antibiotics (last-resort treatments for severe, multidrug-resistant infections).

Watch and reserve antibiotics are not intended for initial treatment and their use should be limited only to those who need them to maintain their effectiveness and reduce the development of resistance. In contrast, access antibiotics are those that are more commonly available and used to treat common infections due to their lower potential for increasing resistance.

Between 2019 and 2021, watch antibiotic use increased by 160% in Southeast Asia and 126% in Africa. During the same period, use of reserve antibiotics increased by 45% in Southeast Asia and by 125% in Africa.

Worldwide, 2 million of more than 3 million child deaths were associated with the use of watches and backup antibiotics.

While the increase in the use of watches and backup antibiotics may be necessary in response to the concurrent increase in drug-resistant infections, the sharp increase in the use of these drugs poses several serious long-term risks. Their increased use, especially without careful supervision, increases the risk of resistance and limits future treatment options. When bacteria develop resistance to these antibiotics, there are few alternatives for treating multi-resistance infections. “

Professor Joseph Harwell, study co-author

Several factors contribute to the severity of AMR in low- and middle-income countries, including overcrowded hospitals, poor hygiene, and weak infection prevention measures that facilitate the spread of resistant pathogens in health care and community settings. Due to the lack of diagnostic tools and concerns about misdiagnosis, overuse and misuse of antibiotics are also common in these regions. Furthermore, many low- and middle-income countries lack effective national surveillance and antimicrobial stewardship programs, making it difficult to track resistance trends and establish effective treatment protocols.

“Increasing resistance to observation and back-up antibiotics will ultimately lead to higher levels of treatment failure,” Professor Harwell said. “Mortality rates, already alarmingly high, will continue to rise significantly, particularly in low- and middle-income countries where access to alternative treatments and advanced medical interventions are limited.”

Professor Harwell promoted: "Answering this problem requires urgent and coordinated action at both regional and global levels. Global and national surveillance for AMR must adopt a 'public health' approach with cost-effective systems that can inform treatment guidelines and measure the impact of control interventions."

"At a regional level, we urge policymakers to enforce hospital antimicrobial stewardship programs in all pediatric healthcare settings. Improved age classifications in surveillance data will also increase our understanding of important differences in resistance rates across categories of age, and the turnover of pediatric-specific resistance mechanisms. Use," Professor Harwell concluded.

Sources: