Does this mean antibiotics won't work for my child's infections anymore?

Not immediately, and not across the board — but the trajectory is concerning for certain organisms and drug classes. Most common childhood bacterial infections remain treatable. What the data signals is that first-line antibiotic choices are narrowing for some pathogens, and that the drugs held in reserve for resistant infections need to be preserved carefully. Taking antibiotics only when prescribed, completing the course as directed, and not requesting antibiotics for viral illnesses (colds, most sore throats, most chest infections) directly supports this.

Why does trimethoprim no longer work as well for urinary tract infections?

Trimethoprim resistance has risen significantly in Australian uropathogens — the bacteria that cause UTIs. This is a worldwide phenomenon driven by decades of use. The practical implication is that your GP may no longer prescribe trimethoprim as the default first choice for a UTI, instead choosing an alternative based on the most likely organism and your individual circumstances. A midstream urine culture — even for straightforward UTIs — lets the laboratory tell the prescribing doctor which antibiotic the specific bacteria causing the infection will respond to.

Children's antibiotic resistance is rising everywhere — an AU-led study

What just happened

A major global study led by Melbourne’s Murdoch Children’s Research Institute, published in JAMA Paediatrics, has found that antimicrobial resistance in children is rising across every country examined — all 82 of them.

The study analysed data from 106,581 children aged zero to 18 collected across the 18 years from 2004 to 2022 using the ATLAS global resistance surveillance database. The headline finding is unambiguous: resistance trends are worsening universally. The most clinically worrying pattern is that resistance is rising fastest in the Watch and Reserve antibiotic categories — the drugs held back specifically for infections that cannot be treated with Access-tier agents.

In plain terms: the backup medications are becoming less reliable faster than the first-line ones.

Both-and

What makes this significant

The scale of the study and the breadth of the country coverage distinguish this from earlier resistance snapshots. Eighty-two countries, nearly 107,000 paediatric cases, almost two decades of trend data — this is not a regional signal. It is a global pattern, and one that includes Australia.

The organisms driving the most concerning trends are Gram-negative bacteria responsible for severe infections: Acinetobacter baumannii, the cause of hospital-acquired bloodstream infections and pneumonia, and Klebsiella, associated with urinary tract infections and liver infections. These are pathogens where resistance to Reserve-category antibiotics — the ones used when everything else has failed — is the practical endpoint of an untreatable infection.

Professor Mark Morgan from Bond University, commenting for RACGP’s NewsGP, framed the stakes clearly: “Many of the things we take for granted may become much riskier in the future.” That is not alarmism. It is an accurate description of where the resistance curve is pointing.

The Australian GP picture

Australian GPs prescribe the majority of antibiotics dispensed in this country — and that makes general practice the fulcrum of national stewardship. The good news is that Australian antibiotic use is lower than the 2015 peak, a reflection of prescribing behaviour and public campaigns. The less encouraging news is that use has risen again recently, and the tracking of appropriateness remains incomplete.

The most immediate concrete impact for patients in general practice: trimethoprim — for decades the go-to first-line agent for uncomplicated urinary tract infections — is no longer the default in many Australian settings because of documented resistance among common uropathogens. The RACGP article names this explicitly. For a 45-year-old woman who has been prescribed trimethoprim every time she presents with a UTI, this shift may mean a different prescription, or a urine culture to guide choice, the next time she comes in.

What the data doesn’t capture

The ATLAS database has gaps. Privately dispensed antibiotics in Australia are not fully tracked, and the appropriateness of prescribing — whether each prescription was genuinely indicated — is not measured in resistance surveillance. This is a known limitation of resistance data globally: we know resistance is rising, but we cannot fully separate the contribution of overprescribing from transmission.

The study focused on children, and the resistance trends it documents are most directly applicable to paediatric infections. Adult resistance patterns follow similar trajectories but are driven by a different prescribing volume and pathogen mix.

My two cents

Antimicrobial resistance tends to get presented as a large systemic problem — a threat to surgery, to chemotherapy, to intensive care — that feels distant from a GP visit for a child’s ear infection or a self-limiting UTI. The framing is not wrong, but it misses where the trajectory is determined.

The trajectory is determined prescription by prescription. Not in aggregate, not in policy documents, but in each individual clinical encounter where the decision is whether this particular infection actually requires an antibiotic — and if so, which one, at what dose, for how many days.

For patients, the most useful understanding is a simple one: antibiotics change bacterial ecosystems, including your own. Every course of antibiotics you take — particularly courses that are not needed, or that are cut short because you felt better — shapes the resistance landscape your future self will inherit. That is not a guilt trip; it is a systems-level fact that becomes meaningful at the individual level.

The two most consequential actions any patient can take are: not requesting antibiotics for viral illnesses, and completing prescribed courses. Those two things, multiplied across a population, are what resistance trajectories are made of.

Verdict: yes — global study from an Australian research institute, with a direct general practice stewardship implication for Australian GPs and patients.

Sources cited

Sharp rise in antimicrobial resistance among children. RACGP NewsGP, July 2026. https://www1.racgp.org.au/newsgp/clinical/sharp-rise-in-antimicrobial-resistance-among-child
Antimicrobial resistance in paediatric infections 2004–2022. JAMA Paediatrics, 2026. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2851769