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Threat of Drug-Resistant E. Coli Increases with Pediatric Antibiotic Prescriptions

Antibiotics may become ineffective treating E. Coli if antibiotic resistance continues to increase among children.
Published Online: Feb 13,2018
Gina Kokosky, Editorial Intern
E. Coli is the most prevalent cause of urinary tract infections (UTIs) in pediatric patients, with the bacteria involved with 80% of infections. Infections in this age group are typically treated by antibiotics.

However, children who have previously been treated with antibiotics are becoming resistant to the antibiotic treatment for E. Coli, according to findings from a study published by The Journal of Antimicrobial Chemotherapy

The increase in resistance may render the antibiotic treatment of E. Coli ineffective in the future, according to the authors.

Antibiotic resistance is a growing public health threat, with 10 million patients per year potentially at risk of antibiotic-resistant infections by 2050. Researchers compare the threat of antibiotic resistance to that of pandemic flu, according to the authors of the current study.

Children are often prescribed antibiotics to treat common illnesses; however, a high frequency of antibiotic use as a child has been proven to increase the risk of antibiotic resistance in adulthood. There is currently limited knowledge about the occurrence of antibiotic resistance in children, according to the authors.

In the study, the researchers examined the rate of antibiotic resistance among pre-school children who developed UTIs from E. Coli. Risk factors, such as previous antibiotic exposure, were also examined, according to the authors.

Secondary data were analyzed from 824 children under the age of 5 who were receiving primary care treatment for a UTI.

The authors found that common antibiotics, including amoxicillin, trimethoprim, and co-amoxiclav,  were observed to increase the prevalence of antibiotic resistance upon regular exposure. Additionally, one-third of UTIs caused by E. Coli were resistant to more than 3 types of antibiotics, according to the findings.

Children were also likely to resist antibiotic treatment for E. Coli if they were exposed to antibiotics within the past 3 months, according to the authors.

“Our study shows that antibiotic resistance to this common bacteria found in children is high, especially when antibiotics have previously been recently prescribed,” said study author Ashley Bryce, PhD. “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.”

The authors suggest that primary care physicians should consider whether antibiotic treatment is necessary to treat at UTI prior to prescribing.

“Future research must prioritise [sic] increasing our understanding of antibiotic resistance in bacteria that commonly cause infections, so that prescribing guidelines can be updated to improve patient outcomes,” said co-author Cèire Costelloe, PhD.