VoICE Immunization Evidence: Antibiotic Resistance
The pneumococcal conjugate vaccine has been shown to significantly reduce the rate of antibiotic and multi-drug resistant strains of pneumococcal disease
Key Evidence: A large U.S. study of surveillance data examining the impact of switching from PCV7 to PCV13 for infants demonstrated how important vaccination is in combating antimicrobial resistance. While the incidence of antibiotic-resistant invasive pneumococcal disease (IPD) was increasing before the introduction of PCV13, drug resistant IPD declined 78-96% in children under five after the vaccine introduction.
Moore MR, Link-Gelles R, Schaffner W et al. 2015. Effect of use of 13-valent PCV in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance. Lancet. 15.
Key Evidence: This study from South Africa demonstrates significant declines in invasive pneumococcal disease cases caused by bacteria that are resistant to one or more antibiotics. In fact, the rate of infections resistant to two different antibiotics declined nearly twice as much as infections that could be treated with antibiotics.
Von Gottberg, A., de Gouveia, L., Tempia, S., et al 2014. Effects of pneumococcal vaccine in invasive pneumococcal disease in South Africa. New England Journal of Medicine. 371:1889-99.
Key Evidence: Studies in several countries have shown that, following the introduction of pneumococcal conjugate vaccine, there was a reduction in the number and percent of drug-resistant cases of pneumococcal diseases in children, and in some countries in adults, due to herd effects. In Japan there was a 10-fold decline in the proportion of penicillin-resistance among cases of invasive pneumococcal disease (from 56% to 5%), and in the U.S. there were reductions of 81% and 49% in the proportion of penicillin-resistant cases in children less than two years and in adults more than 65 years old, respectively.
Klugman KP, Black S 2018. Impact of existing vaccines in reducing antibiotic resistance: primary and secondary effects. Proceedings of the National Academy of Sciences. 115(51).