腹疫苗对儿童抗生素使用的影响在五个资源较低的环境中:一个比较模拟研究
Elizabeth T Rogawski McQuade1, Stephanie A Brennhofer2, Sarah E Elwood2
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
The Lancet. Global health
|November 22, 2024
概括
肠道疫苗可以预防每100名儿童每年服用8-12次抗生素. 组合疫苗是显著减少低资源环境中整体抗生素使用的关键.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 疫苗学 疫苗学 疫苗学
背景情况:
- 抗生素耐药性是一个日益严重的全球健康问题.
- 腹性疾病是低资源环境中致病率和死亡率的主要原因.
- 对腹的抗生素使用有助于抗菌素耐药性.
研究的目的:
- 量化肠道疫苗对抗生素使用的潜在影响.
- 为了比较单个病原体与组合疫苗在减少抗生素消耗方面的有效性.
- 模拟疫苗对抗生素治疗腹和整体抗生素暴露的影响.
主要方法:
- 来自五个国家的纵向出生队列的分析 (孟加拉国,印度,尼泊尔,巴基斯坦,坦桑尼亚).
- 蒙特卡洛模拟用于模拟九种疫苗接种场景 (六种单一,三种组合疫苗).
- 估计抗生素治疗腹,整体抗生素疗程和旁观者病原体暴露的减少.
主要成果:
- 一种西格拉疫苗显示出所有原因的腹抗生素疗程的最大减少 (每100个儿童年减少8.2个疗程).
- 一种腺病毒 - 诺病毒 - 转基因病毒疫苗在组合疫苗中显示出抗生素使用的最大减少 (-12.2个疗程/100个儿童年).
- 2021年疫苗对抗生素使用的影响预计比2009-12年低45-74%,原因是腹发病率下降.
结论:
- 肠道疫苗有望减少抗生素的使用,可能每年预防每100名儿童8-12个疗程.
- 组合疫苗可能是必要的,以实现大幅减少 (大于1%) 的总抗生素使用.
- 疫苗对抗生素使用的影响可能会随着时间的推移而减少腹发病率.
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