The World Health Organization has been urged to revise its guidelines regarding the use of antibiotics in developing nations after a groundbreaking study revealed that thousands of infants are succumbing to preventable infections. This alarming revelation has sparked discussions about the efficacy of current medical practices in these regions. The study, which spanned 11 countries and included over 3,200 newborns, stands out as one of the largest of its kind ever conducted. It suggests that established policies in Western countries regarding antibiotic usage may inadvertently be causing more harm than good in Africa and other developing areas, highlighting an urgent need for updated protocols.
Conducted by the Global Antibiotic Research and Development Partnership, this study specifically examined the rates of sepsis—a severe and life-threatening response to infection—in neonatal infants. The findings revealed a staggering “extensive variation in mortality” among the 19 hospitals involved in the research, with death rates ranging from 1.6% to a shocking 27.3%. These figures indicate markedly higher mortality rates in low- and middle-income countries (LMICs), underscoring the critical need for tailored medical interventions in these regions.
“The WHO guidelines are clearly outdated,” stated Professor Angela Dramowski, a pediatric infectious diseases expert at Stellenbosch University in Cape Town and a lead author of the research paper. She emphasized that previous guidelines were formulated based on experiences in high-income countries and then improperly applied to the African context, which has resulted in a significant disconnect between recommended practices and actual healthcare needs in these regions.
In the context of the WHO recommendations for sepsis treatment, the second factor raised by Prof. Dramowski is particularly crucial. She explained, “The profile of pathogens and antimicrobial resistance (AMR) rates in LMICs make the suggested antibiotics less likely to be effective in neonatal units.” This indicates that the pathogens prevalent in these regions differ significantly from those in wealthier countries, thus necessitating a reevaluation of treatment protocols to better suit the local population.
Seamus O’Brien, Director of Research & Development at the Global Antibiotic Research & Development Partnership, expressed his surprise at the study’s findings. He noted that globally, there are approximately 600,000 deaths from sepsis each year, with 200,000 attributed to antimicrobial resistance, according to Prof. Dramowski. Alarmingly, around 95% of these fatalities occur in low- and middle-income countries, highlighting the urgent need for improved healthcare strategies in these vulnerable populations.
Prof. Dramowski also pointed out that experts believe the actual number of infants dying from infections is grossly underestimated. Preterm infants, in particular, are exceedingly susceptible to infections due to their underdeveloped immune systems. “They have very fragile barriers; everything that typically protects us from infection, such as intact skin and a fully developed gastrointestinal tract, is underdeveloped in them. Moreover, they often remain hospitalized for extended periods, which further increases their risk of exposure to infections,” she explained, emphasizing the need for urgent action to protect these vulnerable lives.
