The level of antibiotic resistance in neonatal infections and its impact on mortality in low- and middle-income countries (LMICs) is unacceptably high.  

However, the extent of the impact of AMR linked to neonatal sepsis remains poorly understood in these countries, where access to tests to diagnose infections are limited.  

Previous studies have found high rates of antibiotic resistance in LMICs, including against first-and second-line treatments recommended by the World Health Organisation (WHO). We need to understand how effective these treatments are in LMIC hospital settings, as current guidelines are based mostly on data from high-income countries (HICs).

The BARNARDS study aims to fill some of these data gaps to help build a picture of the true impact of AMR in cases of neonatal sepsis in LMICs.

6,300 children under 1 month old die every day

LMICs bear the burden of 99% of neonatal mortality worldwide

What is the BARNARDS study?

The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) study aims to provide essential data about the impact of AMR in neonatal sepsis across multiple LMICs. The study is currently in its second phase, building on the work of the BARNARDS I project from 2015-2018.  

Our researchers work with new mothers and babies, doctors and clinicians in countries with high rates of neonatal sepsis. We work with a network of 19 hospitals across six countries-  Nigeria, Pakistan, Bangladesh, Rwanda, Sierra Leone, Ethiopia.  

BARNARDS II aims to:

  • Investigate the bacteria which commonly cause sepsis, and can be resistant to antibiotics, to understand their prevalence in LMICs
  • Assess current antibiotic usage at sites, and how affordability and access to antibiotics impacts treatment and outcomes
  • Use samples taken from hospital surfaces to investigate these as a potential source of infection
  • Identify clinical, demographic and economic factors that may be risk factors for developing sepsis or antibiotic-resistant infections 

This data can then be used to evaluate how appropriate current treatment guidelines are for these countries, and others with similar resources. This can enable health bodies, policy makers, NGOS and other key stakeholders to advocate for reviews of antibiotic supply chains.

This research was originally funded by the Bill and Melinda Gates Foundation, and is now continued by the Ineos Oxford Institute. 

BARNARDS research spotlights and news

Find out more about the projects within BARNARDS.