A review of the effect of immunization programs on antimicrobial utilizationArchived
Antimicrobial stewardship policies are increasingly being implemented as a measure to prevent and control antimicrobial resistance. Of note, immunisation and infection control are rarely included as part of antimicrobial stewardship programmes, which rather focus on the prudent use of antimicrobials.
Wilby KJ, Werry D. Vaccine. 2012 Oct 12;30(46):6509-14. doi: 10.1016/j.vaccine.2012.08.031.
Antimicrobial stewardship policies are increasingly being implemented as a measure to prevent and control antimicrobial resistance. Of note, immunisation and infection control are rarely included as part of antimicrobial stewardship programmes, which rather focus on the prudent use of antimicrobials.
However, this review shows that vaccination against pneumococcal disease reduces the use of antibiotics by reducing the morbidity related to pneumococcal pneumonia and otitis media, and vaccination against influenza reduces the use of antibiotics that are prescribed to treat bacterial complications of influenza or prescribed prophylactically in the fear of such complications (the latter is not a recommended practice and is an example of inappropriate use of antibiotics).
On the other hand, there is the question of whether vaccines might alter the epidemiology of a disease, e.g., whether pneumococcal immunisation programmes might result in an increasing number of infections caused by resistant strains of serogroups not covered by the vaccine. This issue is acknowledged by the authors themselves; however, the review shows that despite a possible increase in antibiotic use due to these resistant infections, the overall resulting effect still is a decrease in antibiotic utilization as a result of the immunisation programme.
