低收入和中等收入国家的儿童疫苗和抗生素使用
Joseph A Lewnard1,2,3, Nathan C Lo4, Nimalan Arinaminpathy5
1Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA. jlewnard@berkeley.edu.
Nature
|May 8, 2020
概括
通过预防感染, 疫苗显著减少了低收入国家的幼儿使用抗生素. 肺炎球菌和轮状病毒疫苗是打击抗菌素耐药性和减少疾病发病的关键.
科学领域:
- 全球健康
- 传染性疾病
- 疫苗学
背景情况:
- 抗菌素耐药性 (AMR) 是全球主要的健康威胁,特别是在低收入和中等收入国家 (LMICs).
- 对感染的抗生素消费有助于AMR,但疫苗对这一消费的影响在LMIC中尚不清楚.
研究的目的:
- 量化最近实施的疫苗对LMIC五岁以下儿童抗生素消耗的影响.
- 评估疫苗在减少用抗生素治疗的感染和支持抗生素耐药性的全球战略中的作用.
主要方法:
- 在LMIC中进行大规模家庭研究的分析.
- 对抗生素治疗的急性呼吸道感染和腹的疫苗有效性的估计.
- 根据目前和普遍的疫苗覆盖范围,预防使用抗生素治疗的疾病发作.
主要成果:
- 肺炎球菌结合疫苗 (PCV) 和活体减弱型轮状病毒疫苗 (RV) 大大降低了抗生素消耗.
- 抗生素治疗的急性呼吸道感染和腹对PCV的保护率分别为19. 7%和11. 4%.
- 目前的疫苗覆盖率每年可以防止数以百万计的抗生素治疗发作,在普遍覆盖率上可能会产生更大的影响.
结论:
- 通过世卫组织扩大免疫计划实施的疫苗显著减少了LMIC中幼儿的抗生素使用.
- 对抗抗微生物药物耐药性的全球战略来说,优先考虑疫苗至关重要.
- 疫苗覆盖率的提高有助于减少使用抗生素治疗的疾病.
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