Vaccines Play a Key Role In Reducing Resistance

Around the globe, health officials are working together this week to raise awareness and encourage best antibiotic prescribing practices during World Antibiotic Awareness Week.

Although not directly related to the global campaign, health officials at the National Foundation for Infectious Diseases (NFID) discussed one way to address the issues of circulating resistant organisms: through vaccination.Scott Fridkin, MD, from the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention and Jane Knisely, PhD, from the National Institutes of Health discussed the importance of vaccination and prophylactic immune interventions, as a way to reduce resistant bacteria during an NFID webinar.¹

In addition to helping to reduce antibiotic resistance by lowering the number of antibiotics prescribed, vaccination can prevent recurrent disease and prevent subsequent infection to other unvaccinated individuals, Dr Fridkin said. Individuals who have been vaccinated will also decrease the chance they will be hospitalized. 

“By keeping them out of the healthcare system, the rate of bacterial infection decreases,” Dr Fridkin continued.

The pneumococcal vaccine, PCV7, is one of many vaccines that have contributed to reducing antibiotic use, according to information presented during the webinar. Data from the Kaiser Permanente Research Group in California demonstrated that PCV7 reduced the number of otitis visits for children who were vaccinated when compared with control children, and that the vaccine was associated with a reduction in antibiotic prescriptions by 5.4%. ² Data like these present a strong case for research into other vaccines to prevent spread of illnesses, the speakers noted. 

Dr Knisely explained that Clostridium difficile infection, methicillin-resistant Staphylococcus aureus, and Neisseria gonorrhea are all areas in critical need of vaccine development.

Although vaccines for all three infections currently are in various stages of clinical trials, it generally takes years to bring a vaccine to market, because they require large testing populations and generally need to be low cost, Dr Knisley said.

Prophylactic immune interventions like monoclonal antibodies could broaden infection prevention, according to Dr Knisely.  These interventions would allow clinicians to treat smaller, high-risk target populations and would require a less stringent requirement for durable immune response.

Monocloncal antibodies are in development for C. difficile, hospital-acquired pneumonia, Shiga toxin E. coli, among other pathogens, Dr Knisley explained.

“Vaccines and prophylactic immune interventions are an important piece of this antimicrobial puzzle,” Dr Knisely said. 

Reference

1.      Fridkin SK and Knisely JM. Addressing Antimicrobial Resistance through Vaccines. Presented by the National Foundation for Infectious Diseases, Nov. 18, 2015.

2.      Fireman B, Black SB, Shinefield HR, et al. Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J. 2003;22:10-16.