Antimicrobial resistance is one of the greatest challenges to public health of the 21st century, and threatens to undermine the gains made in combating child mortality over recent decades. In fact, neonatal sepsis remains one of the most common causes of death in babies across the world, especially in Kenya. We are conducting studies to investigate the use of a new treatment regimen to combat sepsis (bloodstream infections) in babies, which will also be useful as a treatment for older children who have resistant bacterial infections.

Our research is focussed on an antibiotic called fosfomycin, which is commonly used in adults to treat urinary tract infections and has been available since the 1970s, so its safety data is well known and it is also affordable (as it is off-patent). However, research is needed to identify the best dosage regimen for how this medication should be used in babies. To this end, we are currently conducting a pharmacokinetic study to analyse this data. Eventually, we hope to be able to provide this treatment (along with another antibiotic) as a new empirical regimen for babies with bloodstream infections worldwide, to combat infections from antibiotic-resistant organisms.

We know fosfomycin is effective in treating infections caused by local bacteria species, as we have recently analysed its ability to kill bacteria causing bloodstream infections in children presenting to Kilifi hospital over the last 5 years in our microbiology lab. In fact, we found that fosfomycin was effective at killing 90% of bacterial bloodstream infections in children, which is a significant improvement above the approximately 50% of infections which are resistant to the currently-used first-line antibiotic therapy.

By combining the data from our microbiology project with the pharmacokinetic analysis on babies admitted in the ward, we hope to be able to contribute to the development of a large, international randomised controlled trial which will look at the efficacy of fosfomycin in treating neonatal sepsis, to update the current empirical therapy to a treatment regimen which is better able to combat neonatal (and paediatric) sepsis.