A study in The Lancet Regional Health exposes significant gaps in the effectiveness of WHO-recommended antibiotic regimens for serious infections in Southeast Asian and Pacific children, underscoring the urgent need for region-specific treatment guidelines to combat rising antimicrobial resistance.
By Vijay Kumar MalesuNov 5 2023Reviewed by Benedette Cuffari, M.Sc. In a recent study published in The Lancet Regional Health, researchers evaluate the effectiveness of commonly prescribed antibiotics for treating severe bacterial infections in children in Southeast Asia and the Pacific using a Bayesian Weighted Incidence Syndromic Combination Antibiogram model.
Nevertheless, detailed data on infection rates and resistance patterns in LMICs, particularly in Asia, remains sparse. Challenges like culture-negative bacterial infections make targeted treatments challenging, thus increasing reliance on empirical antibiotics. Two reviewers independently screened titles and abstracts for inclusion, with disagreements addressed by a third party. The Grades of Recommendation, Assessment, Development, and Evaluation and Microbiology Investigation Criteria for Reporting Objectively frameworks helped assess the quality of evidence.
Study findings The systematic review gathered information from 151 publications representing 11 countries across WHO-defined Southeast Asia and Western Pacific Regions. However, 65 publications that focused solely on one pathogen were excluded to reduce bias. Ultimately, data from 86 publications were utilized, spanning 1990 to 2019. These studies covered various clinical contexts, with only one focusing on a rural population.
In pediatric sepsis, E. coli, Staphylococcus aureus, and Streptococcus pneumoniae were frequent pathogens in 26%, 20%, and 13% of cases, respectively. The profile of pathogens in pediatric meningitis was somewhat similar, with S. pneumoniae being the leading cause in older children, followed by E. coli at 43% and 27%, respectively.
In pediatric sepsis, coverage rates included aminopenicillins at 37%, gentamicin at 39%, cefotaxime/ceftriaxone at 51%, and carbapenems at 83%. For pediatric meningitis, the coverage was estimated to be aminopenicillins, gentamicin, cefotaxime/ceftriaxone, and carbapenems in 62%, 21%, 65%, and 79% of cases, respectively.
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