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Outpatient antibiotic use in Dutch infants after 10-valent pneumococcal vaccine introduction: a time-series analysis

Alexandre C Fortanier1, Roderick P Venekamp1, Rebecca K Stellato1

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.

BMJ Open
|July 2, 2018
PubMed

Insights

Switching from the 7-valent to the 10-valent pneumococcal conjugate vaccine (PCV) in Dutch infants modestly reduced outpatient antibiotic use. Geographical vaccination coverage did not significantly modify this association.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • The introduction of pneumococcal conjugate vaccines (PCVs) has significantly impacted childhood infectious diseases.
  • Understanding the effects of vaccine composition changes on antibiotic use is crucial for antimicrobial stewardship.

Purpose of the Study:

  • To evaluate the impact of switching from a 7-valent PCV (PCV7) to a 10-valent PCV (PCV10) on antibiotic consumption in Dutch infants.
  • To determine if geographical vaccination coverage influences the association between PCV switch and antibiotic use.

Main Methods:

  • A population-based cohort study utilizing anonymized antibiotic purchase data from 255,154 Dutch infants (aged <2 years) between 2006 and 2013.
  • Time-series analysis was employed to estimate changes in monthly antibiotic use before and after PCV10 introduction, accounting for seasonality and autocorrelation.
  • The study investigated potential interactions between vaccination coverage levels and the observed changes in antibiotic use.

Main Results:

  • The introduction of PCV10 was associated with a 1.6% overall reduction in infant antibiotic use (Purchase Rate Ratio: 0.98).
  • A significant shift in the trend of antibiotic use was observed post-PCV10 introduction, with a decrease in prescriptions compared to the PCV7 period.
  • No significant evidence was found that PCV vaccination coverage modified the association, though the study may have lacked power to detect such effects.

Conclusions:

  • The transition from PCV7 to PCV10 in the Netherlands was linked to a modest decrease in outpatient antibiotic consumption among infants.
  • Further research with enhanced statistical power may be needed to fully elucidate the role of vaccination coverage in this association.
Abstract

Keywords:
epidemiologypublic health

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