Out of sync: antimicrobial drug development for children

The global incidence of antibiotic-resistant infections is increasing due to inappropriate use in human health, animal health, food production, and the environment. In 2019, bacterial antimicrobial resistance was responsible for 1·27 million deaths, with one in five deaths in children under five years old. The neonatal period has the highest mortality and disability rates, with rates ranging from 4 to 160 times higher in high-income regions and 21 to 450 times higher in sub-Saharan Africa. The post-neonatal period has the second highest rate of deaths due to bacterial antimicrobial resistance. Resistant invasive fungal infections are also increasing, with the burden of these infections in children being almost invisible.