Even as China battles the latest outbreak of respiratory diseases among kids, experts are observing an alarming trend. A Bloomberg report says that medical practitioners are seeing an evident impact of antibiotic resistance in crowded pediatric hospitals across China. The massive outbreak of walking pneumonia, typically considered a mild infection, affecting millions of children, evoked memories of the COVID-19 pandemic and triggered concerns regarding the emergence of a new infectious agent.

However, medical professionals emphasize the real danger of the rising superbugs, a consequence of increasing drug resistance over the years, which reduces the efficacy of vital antibiotics.

After pandemic-control measures were eased, several countries experienced mushrooming of germs and flu-like situations. Hence, the rising bacterial infections caused by mycoplasma pneumoniae initially were not a cause of stress and worry.

The antibiotic azithromycin was prescribed along with the warning that some kids were not showing improvement with the prescribed drug. The child however developed lesions in her lungs and her state went on deteriorating despite being prescribed another stronger antibiotic with an intravenous dosage. The toddler was also treated with other drugs that targeted the inflammation around her heart.

China’s mycoplasma pneumoniae surge had taken Rachel Qiao’s daughter in the first hit. Several others experienced Many others went through similar struggles where the antibiotics failed to reduce the infection which caused them severe pneumonia while doctors were forced to prescribe stronger drugs.

China’s ‘walking’ pneumonia: Is there more to worry about in winters?

With the onset of the winter season, the authorities claim the downfall of respiratory ailments but the parents remain anxious. Last month, the top pediatric medical centers in the country faced overwhelming waiting times, exceeding seven hours. Some parents resorted to bringing their hooks to hang infusion bags filled with medication on hallway walls due to the hospitals running out of space.

These distressing scenes and anxious social media posts prompted widespread speculation both within and beyond China regarding the situation. The World Health Organization, by the end of November, urged Beijing to explain and requested specific information regarding the respiratory pathogens circulating at the time.

China refuted claims of a new infectious agent. Instead, authorities attributed most infections to mycoplasma pneumoniae as of mid-November, albeit with an atypical manifestation. This bacterium is typically associated with sporadic outbreaks and rarely leads to hospitalizations.

The US Centers for Disease Control and Prevention monitored the unfolding situation in China and multiple European countries, while cases began to surface in the United States.

In China, treating children afflicted with mycoplasma pneumoniae infections poses challenges. According to a 2022 study published in JAMA Network Open, nearly 80% of cases show resistance to macrolides, such as Pfizer Inc.’s Zithromax, which was administered to Qiao’s daughter, mentions a report by Bloomberg. In contrast, drug-resistant cases in Europe, America, and Southeast Asia accounted for less than 10%.

Despite high resistance rates, azithromycin remains one of the most commonly used antibiotics in China and is the primary treatment for mycoplasma pneumoniae. However, alternative medications come with side effects like teeth discoloration and bone abnormalities in younger children, leaving physicians with limited effective options.

Experts attribute the elevated resistance levels to the overuse of antibiotics in treating mild infections. In many instances, these drugs are readily available, with doctors prescribing them upon request or as a precautionary measure.

According to a report by Bloomberg, Zuo-Feng Zhang, chair of epidemiology at the University of California, Los Angeles’ Fielding School of Public Health, emphasized that if antibiotics become ineffective, illnesses will persist longer, increasing the risk of spread and the occurrence of large-scale outbreaks.

China’s ‘walking’ pneumonia: Global threat

The situation in China serves as a stark reminder of a global challenge. The World Health Organization (WHO) has warned over the years about the overuse of antibiotics, which has resulted in common bacteria becoming less responsive to existing drugs, labeling it a silent epidemic.

WHO Director-General Tedros Adhanom Ghebreyesus highlighted the severity of the issue in a video released in November during the World Antimicrobial Resistance Awareness Week, stating that antibiotic resistance poses a significant threat, potentially reverting us to a time when even minor infections were incurable.

The consequences of antibiotic resistance are already dire. The WHO reported that it contributed to nearly 5 million deaths worldwide in 2019. Moreover, drug-resistant illnesses are anticipated to result in approximately $1 trillion in healthcare expenses and up to $3.4 trillion in economic losses by 2050, according to the World Bank.

Despite efforts by health authorities in China to curb misuse and educate the public, certain misconceptions persist. For instance, many individuals still view antibiotics as a standard treatment for colds, even though colds are caused by viruses that do not respond to these drugs.

A report by Bloomberg mentions Ben Cowling, chair of epidemiology at the University of Hong Kong’s School of Public Health, who emphasized that widespread use of antibiotics for conditions like colds contributes to increased resistance, making it harder to effectively treat individuals who genuinely require antibiotics.

China’s ‘walking’ pneumonia: Routine IVs

The administration of intravenously infused antibiotics to children with bacterial infections is a relatively common practice in China. While this method can expedite a patient’s recovery, doctors note that in numerous instances, the infection might have naturally cleared up over time, albeit at a slower pace.

“It’s not necessarily a bad choice to opt for it, but it’s also something that might not be indispensable,” remarked Cowling.

However, many Chinese parents are unwilling to endure the wait. “In the US, very few kids have received antibiotics through IV drips before adolescence, but it’s a common procedure in China, even for minor ailments,” pointed out Zhang from UCLA.

Nonetheless, these treatments don’t always yield the desired results. Rachel Qiao’s daughter continues to undergo frequent chest scans and inhale steroids. Although her breathing difficulties have been alleviated and the lung lesions are diminishing, they haven’t disappeared entirely. Doctors remain optimistic about her full recovery.

Yin Yudong, an infectious disease specialist at Beijing Chaoyang Hospital, the nation’s leading respiratory disease center, emphasized the necessity of implementing diverse measures to combat antibiotic drug resistance. He warned in a statement to local media Beijing News in November that without such interventions, there’s a risk of having no effective treatments for children.