An observational study examining nasopharyngeal resistome evolution among children under the selective pressure of antibiotic exposure and hospitalisation for pneumonia in Malawi: A study protocol

Introduction Antimicrobial resistance (AMR) to first line antibiotics for pneumonia is a major global health problem, and AMR-attributable deaths are prevalent in sub-Saharan Africa. Improved data on how AMR develops and influences health outcomes in resource limited settings is crucial. The nasopharynx is a reservoir for pneumonia pathogens and their resistome, the genetic determinants of AMR. No study has explored whether human resistome composition in children with pneumonia is associated with health outcomes. This study will examine whether antibiotic treatment and hospital admission for p

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