A new study found a high prevalence of antibiotic resistance in E. coli bacteria against several commonly prescribed antibiotics. Led by researchers at the University of Bristol and Imperial College London, the study showed that resistance to antibiotics could persist for up to three months after children have taken the medicines.
Bacterial resistance to antibiotics is one of the most challenging global health threats in modern medicine, the authors said. According to some estimates, 10 million lives per year will be at risk from antibiotic-resistant infections by 2050. Previous studies have shown routine use to increase the chance of antibiotic resistance in adults with urinary tract infections (UTIs), but researchers said little is known about the prevalence of bacterial resistance and risk factors in children.
The study was published this week in the Journal of Antimicrobial Chemotherapy and funded by the National Institute for Health Research (NIHR) School for Primary Care Research. Researchers focused on UTIs since they are among the most common antibiotic-resistant infections in primary care. E. coli is the most common cause of UTIs, with more than 80% of infections in children linked to the bacteria.
Researchers conducted a secondary analysis of data from 824 children under the age of five. All of the children had previously been recruited for another study aiming to improve the diagnosis of UTIs in children.
The new study found that nearly a third of all E. coli bacteria were resistant to three or more antibiotic groups, with 43% being resistant to at least one antibiotic. Bacteria demonstrated the highest resistance to amoxicillin, co-amoxiclav, and trimethoprim.
Dr. Ashley Bryce, lead author and a senior research associate at the University of Bristol’s Centre for Academic Primary Care, said, “Our study shows that antibiotic resistance to this common bacteria found in children is high, especially when antibiotics have previously been recently prescribed.”
Such high-level resistance could render these antibiotics ineffective as first-line treatments, researchers warned. As a result, they recommended updating prescribing guidelines to reflect local resistance patterns.
Since children are key transmitters of infections within communities, they could also be recipients and transmitters of antimicrobial-resistant infections. Based on their findings, study authors also urged physicians to consider the necessity of prescribing antibiotics to children.
Dr. Bryce cautioned, “Frequent exposure to antibiotics can disrupt the normal balance of bacteria within the urinary tract and gut, which can lead to increased risk of bacterial infection. GPs should therefore consider the impact and necessity of further antibiotic treatment before prescribing.” Researchers noted this is especially important in primary healthcare, where over 75% of all healthcare antibiotics are prescribed.
Dr Céire Costelloe of Imperial College London, who co-led the research, said, “Future research must prioritize increasing our understanding of antibiotic resistance in bacteria that commonly cause infections, so that prescribing guidelines can be updated to improve patient outcomes.”