Medical research: The impact of childhood vaccination on antibiotic use

The scaling up or introduction of vaccination programmes for pneumococcus and rotavirus, which cause respiratory illness and diarrhoea, has the potential to reduce antibiotic use in children in low- and middle-income countries. The findings, which are published in Nature, support the prioritization of childhood vaccines as part of the global strategy to combat antimicrobial resistance.

Joseph Lewnard and colleagues analysed data from large-scale household surveys conducted in low- and middle-income countries - where the greatest impacts of antibiotic resistance are felt - to estimate the impact of pneumococcal and rotavirus vaccines on antibiotic use in children under five years of age. They found that 24.8% of antibiotic-treated respiratory infections and 21.6% of diarrhoeal infections were caused by pathogens that were susceptible to these vaccines. Children who had received the pneumococcal conjugate or rotavirus vaccines had 8.7% and 8.1% lower chances of antibiotic-treated respiratory and diarrhoeal infections, respectively, compared with unvaccinated children.

The authors estimated that current pneumococcal and rotavirus vaccination programmes prevent approximately 23.8 million episodes of antibiotic-treated respiratory illness and 13.6 million episodes of antibiotic-treated diarrhoeal illnesses among children in low- and middle-income countries annually. An additional 40 million episodes of antibiotic-treated illness may be prevented if coverage levels were improved in countries in which these vaccines are already being used and through the introduction of vaccines in countries in which children do not yet receive them.

doi: 10.1038/s41586-020-2238-4

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