Antibiotic resistance is rising among children worldwide, threatening to make common and potentially deadly infections increasingly difficult to treat, according to a new study that analyzed more than 106,000 infection samples from 82 countries.
The research, led by the Murdoch Children's Research Institute in collaboration with the University of Sydney, the Clinton Health Access Initiative and The Chinese University of Hong Kong, found that resistance increased across every region studied between 2004 and 2022.
The findings raise particular concerns for babies, children in intensive care and those living in countries with limited health care resources. Researchers warned that resistance to some last-line antibiotics could rise sharply by 2035, potentially leaving physicians with fewer options when standard treatments fail.
Drug Resistance Is Rising in Children
Antimicrobial resistance occurs when bacteria evolve in ways that allow them to survive medicines designed to kill them or stop their growth. As resistant bacteria spread, infections that once responded readily to antibiotics can become harder and more expensive to treat.
Children face unique risks because bacterial infections are more common in childhood, while the number of antibiotics approved and suitable for pediatric use is more limited than for adults.
The study found the sharpest increases were in so-called "Watch" and "Reserve" antibiotics, categories the World Health Organization uses to encourage careful prescribing and preserve drugs for infections that no longer respond to first-line treatments.
The threat is especially serious for infections such as pneumonia and sepsis, which can progress rapidly in children.
Researchers noted that about 840,000 deaths among children younger than 5 were associated with antimicrobial resistance in 2021, underscoring the scale of the problem.
Two Bacteria Are Driving the Crisis
The researchers identified Gram-negative bacteria as major contributors to the global rise in resistance.
Acinetobacter baumannii, which can cause hospital-acquired bloodstream infections and pneumonia, showed the highest overall resistance levels in the analysis.
Klebsiella, which can cause urinary tract infections and other serious illnesses, showed the fastest growth in resistance, with particularly concerning trends reported in Southeast Asia, Eastern Europe and the Western Pacific.
The study's forecasting model projects that resistance to carbapenems, a class of antibiotics often reserved for severe infections caused by multidrug-resistant bacteria, could increase substantially by 2035.
For A. baumannii, carbapenem resistance is projected to reach 82% in the modeled scenarios, while in Klebsiella it could reach 35%.
Why the Threat Is Worse in Some Countries
The burden is not evenly distributed. Children in intensive care units and those in countries with fewer health care resources were among the most affected.
In low-income settings, researchers pointed to challenges including limited access to diagnostic testing, inadequate sanitation and unregulated antibiotic use. These factors can make it more difficult to identify the bacteria causing an infection and select the appropriate treatment.
In wealthier countries, researchers said antibiotic overuse and infection control remain important concerns across hospitals, primary care, veterinary medicine and agriculture.
The study team has launched the AMR in Kids platform, which allows users to examine resistance patterns by country, bacteria and antibiotic class while providing forecasts through 2035.
Researchers say better surveillance can help identify emerging threats earlier, but they also emphasize that action cannot wait for more data.
What This Means for Families
The rise of antibiotic resistance does not mean antibiotics are becoming useless. Rather, it highlights the importance of using them appropriately and ensuring that children receive the right drug when a bacterial infection requires treatment.
Families should not pressure health care providers to prescribe antibiotics when they are not medically necessary, particularly for viral illnesses such as most colds and the flu. Antibiotics do not treat viruses, and unnecessary use can contribute to resistance.
For children with serious bacterial infections, however, timely access to effective antibiotics can be critical.
Researchers say the global response will require better infection prevention, stronger surveillance, improved access to diagnostics and child-friendly antibiotic formulations, as well as continued efforts to preserve the effectiveness of existing drugs.
The warning is particularly urgent for children who are medically vulnerable, including those with chronic illnesses or weakened immune systems, who may have fewer treatment options if resistant bacteria take hold.
