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A global study warns that antibiotic resistance is undermining treatment for serious infections in children.
Researchers analyzed 106,581 bacterial samples collected from children aged 0 to 18 in 82 countries between 2004 and 2022.
Their findings, published in JAMA Pediatrics, show that resistance to antibiotics has increased steadily over the past two decades, particularly in babies, children receiving intensive care and those living in resource-limited settings.
Antimicrobial resistance (AMR) occurs when bacteria evolve and become less susceptible to drugs designed to kill them.
As resistance grows, infections become harder to treat, increasing the risk of severe illness and death.
Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Children’s Hospital in New York, told Newsweek that rising antibiotic resistance is a concern for families and clinicians alike.
“We are all concerned about the increased risk of antibiotic resistance in bacteria,” she said. “That translates into thinking before prescribing antibiotics, picking the most focused antibiotic for a proven or presumed bacterial infection and not prolonging antibiotic courses if not warranted.”
She added that parents can also play an important role in slowing resistance. “We often see parents requesting antibiotics for illnesses that we know are viral,” Nachman said. “In those situations antibiotics are not helpful and won’t shorten the illness course and will contribute to the development of resistance in both that child and their family members.”
The researchers examined resistance in bacterial pathogens identified as global priorities by the World Health Organization (WHO), grouping antibiotics according to the WHO’s AWaRe classification system.
This system divides drugs into “Access” antibiotics, which are recommended as first-line treatments; “Watch” antibiotics, which should be used more carefully because they carry a greater risk of driving resistance; and “Reserve” antibiotics, considered last-resort treatments for the most difficult infections.
While resistance was highest overall among commonly used first-line “Access” antibiotics, the researchers observed some of the fastest increases among “Watch” and “Reserve” drugs.
These medications are often relied upon when other treatments fail, raising concerns that options for treating serious childhood infections could become increasingly limited in the coming years.
The trend was driven largely by Gram-negative bacteria, a group of pathogens responsible for severe infections including sepsis and pneumonia.
The study also projected that resistance to carbapenems—a class of antibiotics often reserved for multidrug-resistant infections—will continue to rise through 2035, particularly in Klebsiella species and Acinetobacter baumannii.
Researchers used spatiotemporal forecasting models to estimate how resistance patterns may evolve over the next decade.
Their projections suggest that without significant intervention, growing resistance could further widen the gap between current treatment guidelines and the real-world effectiveness of available antibiotics.
Nachman said preventing further increases in resistance will require cooperation from both doctors and families.
“Antibiotic stewardship is everyone’s job,” she said. “Don’t expect an antibiotic with a viral illness. Don’t expect or ask for a broader antibiotic when a narrow spectrum one will do the job better.”
She also urged parents to follow treatment instructions carefully, rather than saving leftover medicine for future illnesses.
Children are especially vulnerable to the consequences of AMR because they experience high rates of bacterial infections and have fewer antibiotic treatment options than adults.
According to the researchers, approximately 840,000 deaths among children under the age of five were associated with antimicrobial resistance in 2021.
The authors say the findings highlight the urgent need for improved surveillance, responsible antibiotic stewardship and better access to effective treatments for children.
They also launched a new monitoring platform that allows researchers and policymakers to track resistance patterns by country, bacterial species and antibiotic type, while providing forecasts through 2035.
Reference
Hu YJ, Qiu H, Harwell JI, Bryant PA. Childhood Antimicrobial Resistance With Global Forecasts. JAMA Pediatr. Published online July 20, 2026. doi:10.1001/jamapediatrics.2026.2808.
Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang
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