The omission of children from the UK’s antimicrobial strategy must be tackled

The Department for Health and Social Care is developing the UK national action plan (UK-NAP) on antimicrobial resistance (AMR) for 2024-29. The 2022-23 winter surge in cases of group A streptococcus in children and the resultant strain on the antibiotic supply chain were stark reminders that this cohort of the population must not be overlooked in the UK’s AMR strategy. We strongly urge policy makers to recognise the risk that AMR poses to children in the next UK-NAP on AMR.

In the UK and the rest of the world, the burden of AMR—particularly in Gram negative bacteria—and mortality from associated infections are disproportionately experienced by children compared with adults. This difference is especially stark for infants and neonates. A growing body of evidence suggests that exposure to antibiotics during the first few years of life can also have a long term health impact through disruption to the microbiome. Early life antibiotic exposure has been associated with childhood onset asthma, allergic rhinitis, atopic dermatitis, coeliac disease, and obesity, highlighting the specific risks that children face from inappropriate antimicrobial use.