*Children given antibiotics before the age of two may be more likely to suffer from allergies, asthma, and chronic diseases, according to the report.
Over the last decade, the world has seen an unprecedented scale-up of antiretroviral therapy (ART) that has saved the lives of tens of millions of people. As of December 2019, 25.4 million of the estimated 38 million people living with the Human Immuno-deficiency Virus (HIV) earned ART worldwide.
Increased use of ART was not suddenly followed by the advent of any degree of drug resistance to HIV, which has gradually increased in recent years.
HIV drug resistance can jeopardize the effectiveness of antiretroviral drugs used for both HIV treatment and infection prevention and is associated with an increased number of HIV infections and HIV-associated morbidity and mortality.
Combating antimicrobial resistance (AMR), including resistance to HIV medicines, is a global priority that calls for concerted action in all sectors of government and society.
The Global Action Plan on HIV Drug Resistance 2017–2021, aligned with the World Health Organization (WHO) Global Action Plan on Antimicrobial Resistance, identifies key steps for the country and global stakeholders to prevent, track and respond to HIV drug resistance and to accelerate progress towards achieving the global goals for HIV disease control by 2030.
The main acts are as follows:
Prevention and response: incorporate high impact measures to prevent and respond to HIV drug resistance.
Monitoring and surveillance: obtain quality data on HIV drug resistance and HIV service delivery from periodic surveys while increasing regular viral load and HIV drug resistance testing.
Study and innovation: promote important and creative research that will have the greatest effect on public health in minimizing drug resistance to HIV.
Laboratory capacity: promote and improve the use of viral load testing and develop the capacity to track HIV drug resistance.
Governance and supporting mechanisms: ensuring control of the region, coordinated action, advocacy, and sustainable funding are in place to support HIV drug resistance activities.
Antimalarial drug resistance has also emerged in recent years as a challenge to global malaria control efforts, especially in the Greater Mekong sub-region. The much-anticipated Antimalarial Drug Efficacy, Resistance and Response Report: 10 Years of Surveillance (2010–2019) will provide a decade of data on drug efficacy and surveillance and recommendations to preserve the efficacy of malaria treatment in the coming decades.
In the meantime, the study cautioned that children might be more likely to suffer from chronic diseases such as allergies, asthma, eczema, and obesity if antibiotics are given before the age of two.
The full results of the study were published in the Mayo Clinic Proceedings journal.
The United States (U.S.) researchers studied the health records of 14,500 children and found a link between chronic disease and early antibiotic use.
The team has hypothesized that antibiotics—while used to help fight off ‘evil’ bacteria—may have an effect on beneficial microbes that make up our intestinal microbiome.
Allergies—the most common chronic condition among children—infect more than one in four people in the United Kingdom (U.K.) at some point in their lives.
Antibiotics are used to treat bacterial infections such as urinary tract infections but are not effective against viruses such as common colds or coronavirus.
“We would like to emphasize that this study shows an association that does not cause these conditions,” said Nathan LeBrasseur, a paper author and physiologist at the Mayo Clinic in Minnesota.
“These findings provide an opportunity for future research to identify more reliable and safer approaches to timing, dosing, and types of antibiotics for children in this age group,” he added.
In their research Professor, LeBrasseur and colleagues examined the health records of more than 14,500 children—about 70% of whom had been treated with antibiotics before the age of two.
The team found that these children were more likely to develop chronic diseases—including asthma, attention deficit hyperactivity disorder, celiac disease, eczema, food allergies, hay fever, obesity, and weight problems.
“While recent data show an increase in some of the childhood conditions involved in the study, experts are not sure why,” LeBrasseur said.
“Other than the issue of multidrug resistance, the majority of pediatricians have assumed that antibiotics are safe.”
The team also observed that those infants who had undergone several courses of antibiotics were more likely to have more than one chronic illness in their childhood.
The types of illness suffered differ depending on the age of the child, the type of antibiotics they were taking, and how many doses they were administered.
“The ultimate goal is to provide practical guidance for physicians on the safest way to use antibiotics early in life,” LeBrasseur said.
While there are over 100 types of antibiotics, one of the most widely used is amoxicillin—used to treat a number of conditions, including middle ear infections, strep throat, skin infections, pneumonia, and urinary tract infections.