Pediatric ASP Toolkit

Vaccines to Reduce Antibiotic Use

Effective Vaccinations can lead to Decrease in Antibiotic Use by:

  • Reducing incidence of bacterial infections
  • Reducing the fear of serious infectious complications
  • Reducing the incidence of viral infection, in particular influenza, that is frequently mistreated with antibiotics

Antibiotic Use has Decreased Since Introduction of Pneumococcal Vaccination

  • In the United States, rates of antibiotic prescribing to children have declined since the 1990s; since that time period, PCV7 was introduced in 2000 and replaced by PCV13 in 2010, and several national treatment guidelines for common pediatric infections were published during that time period as well.
  • A Danish study on national antibiotic prescribing found the proportion of infants prescribed at least one antibiotic prescription decreased from 40.7% among infants born in 2004 to 34.6% among infants born in 2012; during this time, 2 pneumococcal conjugate vaccines (PCVs) (PCV7 in 2007 and PCV13 in 2010) were introduced along with national antibiotic prescribing guidelines in 2007. (Kinlaw A, Sturmer T, Lund J, et al. Trends in antibiotic use by birth season and birth yearPediatrics. 2017; 140(3):e20170441)
  • Additionally, national outpatient prescribing rates have declined by 6% from 2011 to 2017, with reductions primarily driven by children. Antibiotic prescriptions per 1000 population has declined 16% among children ages 0 to 19 years. (Source: CDC’s office of Antibiotic Stewardship and IQVIA Xponent; data provided by Dr.Laurie Hicks, personal communication)

Antibiotic Resistance has Decreased Since Introduction of Pneumococcal Vaccinations

PCV7

PCV13

Vaccinations Decrease the Incidence of Serious Bacterial Infections

Global Impact

  • The Center for Disease Dynamics, Economics & Policy estimates that universal coverage of children under 5 years with a pneumococcal conjugate vaccine in the 75 countries in their analysis could avert up to 11.4 million days of antibiotics per year. (Laxminarayan, R et al. Access to effective Antibiotics: a worldwide challengeThe Lancet, Volume 387, Issue 10014, 168 – 175)

Cocooning Protects Vulnerable Populations, Specifically Our Neonates

  • Infants less than 6 months of age are too young to have received all doses of vaccine necessary for protection from pertussis, influenza, and others. Unvaccinated adults and family members can be a vector for spreading these diseases to the infant.
  • Administering Tdap during pregnancy, preferably during the third trimester, can reduce annual infant pertussis incidence by more than 13% over postpartum. Also, additional doses to fathers and grandparents can additionally reduce by an additional 16% resulting in lower infant deaths due to pertussis. Pregnancy dose Tdap and postpartum cocooning to prevent infant pertussis: a decision analysis.
  • Other vaccines important in cocooning infants include influenza and measles vaccine.

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