1.2 million people die of drug-resistant infections every year
Antimicrobial resistance is a major threat to newborn and paediatric health globally. Serious bacterial infections remain a leading cause of mortality. Increasingly, many of these bacteria are resistant to standard World Health Organisation (WHO)-recommended first line antibiotic regimens.
The overall goal of the CNPI AMR group is to improve clinical outcomes for neonates and children with serious bacterial infections through prevention and optimal treatment. The group leads global observational and interventional trials focussing on novel strategies to prevent colonisation and disease caused by multi-drug resistant (MDR) pathogens. The group focuses on strategic and regulatory observational and interventional trials of the impact of novel regimens on generic and new antibiotics. The group also has a major interest in the role of optimal use of antibiotics in global policy initiatives to combat AMR worldwide.
Changing the world around us
Our Global Vision & Goals
Our Vision
To improve clinical outcomes for neonates and children with serious bacterial infections through their prevention or optimal treatment.
Scientific Priorities
Our interests are in optimal antimicrobial prescribing and includes determining the best drug, dose, duration, and formulation to the optimal indication to improve clinical outcomes.
Professor Mike Sharland and Dr Julia Bielicki are leading experts globally in antimicrobial prescribing, resistance, and healthcare-associated infections in neonates and children. The AMR team research interests are in optimal antimicrobial prescribing and includes determining the best drug, dose, duration, and formulation to the optimal indication to improve clinical outcomes, while minimising drug toxicity, costs, the selection of resistance, and increasing safety. Another primary interest is in post-marketing surveillance following drug licensing, and long-term surveillance.
The CNPI AMR team work in close collaboration with the Global Antibiotic Research and Development Partnership (GARDP) and the Penta Foundation, a global Paediatric Infectious Diseases research network; the team have collaborated with many global partners to address and combat the emerging threat of AMR, particularly in neonates and children.
Conducting major observational studies and surveys on antibiotic use globally in the ARPEC and GARPEC projects has supported trial planning and hypothesis generation, providing evidence base for conducting global antibiotic interventional clinical trials. This has included clinical trials to determine the optimal choice of drug, dose, duration and delivery to manage hospitalized children with severe pneumonia, including PediCAP.
The AMR team and GARDP have focused on improving an evidence base for the antibiotic management of neonatal sepsis by conducting a global observation study, NeoOBs. This has built on the neonatal sepsis trials in Europe, NeoMero and NeoVanc to establish the design and conduct of a global trial comparing novel antibiotic regiments at different durations to treat MDR neonatal sepsis globally, NeoSep1. A parallel programme, building on the GARPEC point prevalence and blood stream infection studies, aims to provide an evidence base to conduct antibiotic trials and to inform the WHO guideline for paediatric sepsis.
In the low and middle income countries (LMIC) setting the evidence base is very limited and there is a need for preventative interventions such as paediatric infection, prevention and control. This has led to the development of pilot studies to define the optimal choice of antiseptic drug, dose, duration and delivery that prevents vertical and early and late nosocomial/horizontal transmission of MDR bacteria, NeoCHG and NeoVTAMR. This will inform and lead to a final goal of developing a combined intervention bundle to be tested in a global cluster randomization trial to reduce the incidence of neonatal and paediatric Hospital Acquired Infection and improve the quality of prescribing.
