Immunization with PCV7 and PCV13 in Madrid reduced pneumococcal disease and antibiotic resistance

Following the introduction of PCV7 and later PCV13 in Madrid, Spain, there was a 70% reduction in the incidence of invasive pneumococcal disease in children less than 15 years of age. There was also a pronounced decline in the percentages of penicillin- and cefotaxime-resistant strains of the pneumococcus bacteria. After PCV13 was introduced in 2010, cefotaxime resistance among meningitis patients completely disappeared and both cefotaxime and penicillin resistance among non-meningitis cases declined to very low levels (<3%).

The PCV-13 vaccine may increase the susceptibility of antibiotic-resistant bacteria strains

A community-based study in Vietnam found a high percent of children under five years of age were carrying pneumococcal bacteria in their noses and throats that were non-susceptible to commonly-used antibiotics. Of the strains tested, 18% were not susceptible to penicillin, 26% weren’t susceptible to cefotaxime, 76% were not susceptible to meropenem and 14% were not susceptible to all three nor to any of the “macrolide” drugs (e.g., erthromycin and azithromycin). However, 90% of the multi-drug resistant strains are serotypes that are in the 13-strain pneumococcal conjugate vaccine (PCV-13) and thus the introduction of a vaccine is expected to increase the susceptibility of circulating strains of the bacteria.

Influenza vaccines reduce antibiotic use by preventing secondary infections and unnecessary prescriptions for respiratory illnesses

Vaccines against influenza reduce the use of antibiotics that drive drug resistance in bacteria in two ways. First, they prevent secondary bacterial infections caused by influenza, such as pneumonia and otitis media; in Ontario, Canada, the rate of prescribing for influenza-associated antibiotics declined around 64% after universal introduction of influenza vaccination compared to other Canadian provinces with more limited use of the vaccine. Second, they help prevent inappropriate antibiotic prescriptions for respiratory tract infections caused by influenza and other viruses, which account for half of all respiratory illnesses for which antibiotics are prescribed in the U.S.

Switching to PCV13 for infants reduced drug-resistant IPD by 78-96% in children under five

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.

Flu vaccination in children may reduce unnecessary antibiotic prescriptions during influenza season

Among 33,000 preschool children in the UK (who received at least one prescription of amoxicillin) there were ~15% fewer amoxicillin prescriptions given during the influenza season to children who had received the live attenuated influenza vaccine than among children who were not vaccinated. This suggests that flu vaccination may lead to a reduction in excess, inappropriate prescribing of antibiotics for influenza in children.