More Than 3 Million Children Died from AMR-Related Infections in 2022: Urgent Need for Action
A groundbreaking study presented at the ESCMID Global 2025 has brought to light a staggering reality: in 2022, more than 3 million children worldwide died due to infections linked to antimicrobial resistance (AMR). This alarming statistic not only serves as a wake-up call but underscores the pressing need for robust regional and global strategies to tackle pediatric AMR, particularly in high-burden regions such as Southeast Asia and Africa.
The data revealed that in Southeast Asia alone, over 752,000 children died from complications arising from AMR, while Africa saw approximately 659,000 fatalities. Many of these deaths were associated with the misuse of so-called Watch Antibiotics and Reserve Antibiotics, which are intended as last-resort treatments for serious infections. The rampant use of these medications, often without adequate medical supervision, sharply increases the risk of developing drug-resistant strains of bacteria.
Between 2019 and 2021, there was a reported 160% increase in the use of Watch Antibiotics in Southeast Asia and a 126% rise in Africa. The utilization of Reserve Antibiotics also surged significantly during this time, recording a 45% increase in Southeast Asia and 125% in Africa. The concerning trend is that of the reported 3 million child deaths attributed to AMR, 2 million were specifically linked to the use of these high-risk antibiotics.
"The increasing reliance on Watch and Reserve Antibiotics, though seen as necessary in response to the growing tide of drug-resistant infections, poses serious long-term risks," explained Professor Joseph Harwell, a co-author of the study. "This sharp rise in their use, particularly without careful monitoring, heightens the risk of further antibiotic resistance and restricts future treatment options. The development of resistance to these first-line antibiotics could leave healthcare providers with very few, if any, alternatives for treating multi-resistant infections."
The situation is exacerbated in low and middle-income countries where overcrowded healthcare facilities, inadequate sanitation, and insufficient infection prevention measures facilitate the spread of resistant pathogens both in hospitals and communities. Professor Harwell indicates that the mortality rates, which are already alarmingly high, are set to escalate, particularly in these economically disadvantaged nations where access to alternative treatments and advanced medical interventions may be limited.
Addressing the AMR crisis requires urgent and coordinated actions not just at the regional but also at a global level. National health strategies must include concrete steps for antibiotic prescription management, education on proper antibiotic usage, and investment in new antibiotic development to combat resistance. Without immediate action, the future of pediatric healthcare could be severely jeopardized, putting millions of children at unnecessary risk of preventable deaths.
The evidence is clear: the fight against AMR is far from over. As we stand at a critical crossroads, healthcare leaders and policymakers must prioritize effective strategies to control the spread of antibiotic resistance, ensuring the safety and wellbeing of the most vulnerable population—our children. Without decisive action, we risk returning to an era where simple infections could once again become deadly.
The Scale of the Crisis
The data revealed that in Southeast Asia alone, over 752,000 children died from complications arising from AMR, while Africa saw approximately 659,000 fatalities. Many of these deaths were associated with the misuse of so-called Watch Antibiotics and Reserve Antibiotics, which are intended as last-resort treatments for serious infections. The rampant use of these medications, often without adequate medical supervision, sharply increases the risk of developing drug-resistant strains of bacteria.
Rising Trends in Antibiotic Usage
Between 2019 and 2021, there was a reported 160% increase in the use of Watch Antibiotics in Southeast Asia and a 126% rise in Africa. The utilization of Reserve Antibiotics also surged significantly during this time, recording a 45% increase in Southeast Asia and 125% in Africa. The concerning trend is that of the reported 3 million child deaths attributed to AMR, 2 million were specifically linked to the use of these high-risk antibiotics.
Expert Commentary
"The increasing reliance on Watch and Reserve Antibiotics, though seen as necessary in response to the growing tide of drug-resistant infections, poses serious long-term risks," explained Professor Joseph Harwell, a co-author of the study. "This sharp rise in their use, particularly without careful monitoring, heightens the risk of further antibiotic resistance and restricts future treatment options. The development of resistance to these first-line antibiotics could leave healthcare providers with very few, if any, alternatives for treating multi-resistant infections."
Factors Contributing to AMR
The situation is exacerbated in low and middle-income countries where overcrowded healthcare facilities, inadequate sanitation, and insufficient infection prevention measures facilitate the spread of resistant pathogens both in hospitals and communities. Professor Harwell indicates that the mortality rates, which are already alarmingly high, are set to escalate, particularly in these economically disadvantaged nations where access to alternative treatments and advanced medical interventions may be limited.
Call to Action
Addressing the AMR crisis requires urgent and coordinated actions not just at the regional but also at a global level. National health strategies must include concrete steps for antibiotic prescription management, education on proper antibiotic usage, and investment in new antibiotic development to combat resistance. Without immediate action, the future of pediatric healthcare could be severely jeopardized, putting millions of children at unnecessary risk of preventable deaths.
Conclusion
The evidence is clear: the fight against AMR is far from over. As we stand at a critical crossroads, healthcare leaders and policymakers must prioritize effective strategies to control the spread of antibiotic resistance, ensuring the safety and wellbeing of the most vulnerable population—our children. Without decisive action, we risk returning to an era where simple infections could once again become deadly.
Topics Health）
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