For every 100 hospitalised pediatric patients across India who may need a common antibiotic called ampicillin to fight infections, chances are it won’t help 95 of them. In 75% of hospitalised children, especially those younger than one month old, another common antibiotic, gentamycin, may not work.
The reason, according a recent study by pediatricians of Apollo Hospital in Navi Mumbai, is that antibiotic resistance has risen to alarming levels among India’s youngest.

The resistance occurs when a bacterium becomes so powerful that antibiotics fail to check its growth. The main cause for resistance is overuse of antibiotics. The study’s authors Dr Dhanya Dharmapalan and Dr Vijay Yewale presented their findings at a conference in Madrid last month, suggesting setting up an expert group at corporation or district levels to track antibiotic use.

“Resistance levels are so high among neonates (less than a month old) and pediatric patients that the government should at least track sale and use of some high-end antibiotics like colistin and vancomycin,” said Dr Dharmapalan.

The study, published in the March edition of the Journal of Pediatric Infectious Diseases Society, looked at 50,545 reports of blood culture conducted across India’s neonatal and pediatric ICUs over 15 years. “Almost a third of these samples had microbes, with staphylococcus aureus and klebsiella pneumoniae being the most common,” said Dr Yewale, former president of the Indian Academy of Pediatrics. The review found staphylococcus aureus was resistant to most first line antibiotics like erythromycin (53% of the cases).
“Antibiotic resistance is the cause when an E coli infection or a urinary tract infection doesn’t heal soon enough with oral drugs in children,” said Dr Dharmapalan. Such kids need higher dose of antibiotics.

It is estimated that of the 7.5 lakh neonates who die in India every year, 20.8% succumb to infections like sepsis and pneumonia, among others. It is this group that needs antibiotics; overusing antibiotics could cause more resistance.
Pediatrician Dr Bhupendra Avasti concurred that antibiotic resistance in Indian neonatal pediatric ICUs is a medical emergency. He said a five-year study at Surya Hospital in Santa Cruz revealed that the most common infections in NICU are klebsiella pneumoniae, acinetobacter and E coli. “Indian NICUs rarely see gram-positive organisms (which have thick cell wall).Yet, the common practice in hospitals is to start children on drugs meant to treat gram positive superbug called MRSA. This could worsen the resistance,” he said.
The study is perhaps the first largest pooled data on resistance in bloodstream infections in Indian children.