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Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media.
Pediatr Infect Dis J 2006; 25(11):1001-7PI

Abstract

BACKGROUND

Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance.

METHODS

Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7.

RESULTS

The proportion of PCV7-vaccinated children (> or =1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly: 15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001).

CONCLUSION

Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM.

Authors+Show Affiliations

Service de Microbiologie, Centre Hospitalier Intercommunal de Creteil, Créteil, France. robert.cohen@wanadoo.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17072121

Citation

Cohen, Robert, et al. "Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use On Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media." The Pediatric Infectious Disease Journal, vol. 25, no. 11, 2006, pp. 1001-7.
Cohen R, Levy C, de La Rocque F, et al. Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media. Pediatr Infect Dis J. 2006;25(11):1001-7.
Cohen, R., Levy, C., de La Rocque, F., Gelbert, N., Wollner, A., Fritzell, B., ... Varon, E. (2006). Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media. The Pediatric Infectious Disease Journal, 25(11), pp. 1001-7.
Cohen R, et al. Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use On Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media. Pediatr Infect Dis J. 2006;25(11):1001-7. PubMed PMID: 17072121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media. AU - Cohen,Robert, AU - Levy,Corinne, AU - de La Rocque,France, AU - Gelbert,Nathalie, AU - Wollner,Alain, AU - Fritzell,Bernard, AU - Bonnet,Eric, AU - Tetelboum,Robert, AU - Varon,Emmanuelle, PY - 2006/10/31/pubmed PY - 2006/12/22/medline PY - 2006/10/31/entrez SP - 1001 EP - 7 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 25 IS - 11 N2 - BACKGROUND: Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance. METHODS: Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7. RESULTS: The proportion of PCV7-vaccinated children (> or =1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly: 15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001). CONCLUSION: Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/17072121/Impact_of_pneumococcal_conjugate_vaccine_and_of_reduction_of_antibiotic_use_on_nasopharyngeal_carriage_of_nonsusceptible_pneumococci_in_children_with_acute_otitis_media_ L2 - http://Insights.ovid.com/pubmed?pmid=17072121 DB - PRIME DP - Unbound Medicine ER -