Observational studyBMC infectious diseases2018
Impact of the 10-valent pneumococcal conjugate vaccine on antimicrobial prescriptions in young children: a whole population study.
Observational study in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Systematic review of the efficacy, effectiveness and impact of high-valency pneumococcal conjugate vaccines on otitis media.Human vaccines & immunotherapeutics · 2022Pooled it
- Effect of vaccination on the use of antimicrobial agents: a systematic literature review.Annals of medicine · 2020Pooled it
- Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map.PLoS medicine · 2019Pooled it
- Impact of Streptococcus salivarius K12 on Nasopharyngeal and Saliva Microbiome: A Randomized Controlled Trial.The Pediatric infectious disease journal · 2021Trial
- The global economic burden of antibiotic-resistant infections and the potential impact of bacterial vaccines: a modelling study.BMJ global health · 2025Article
- Healthcare as a driver, reservoir and amplifier of antimicrobial resistance: opportunities for interventions.Nature reviews. Microbiology · 2024Review
- Nasopharyngeal Carriage of Streptococcus pneumoniae Among Young Children in Haiti Before Pneumococcal Conjugate Vaccine Introduction.The Journal of infectious diseases · 2021Article
- Metrics for evaluating antibiotic use and prescribing in outpatient settings.JAC-antimicrobial resistance · 2021Review
- Encouraging rational antibiotic prescribing behaviour in primary care - prescribing practice among children aged 0-4 years 2016-2018: an observational study.Scandinavian journal of primary health care · 2021Observational
- Prescriptions of antibiotics in out-of-hours primary care setting in Reykjavik capital area.Scandinavian journal of primary health care · 2020Article
- Incidence and etiology of clinically-attended, antibiotic-treated diarrhea among children under five years of age in low- and middle-income countries: Evidence from the Global Enteric Multicenter Study.PLoS neglected tropical diseases · 2020Article
- Development of Next GenerationVaccines · 2020Review
- Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland.PloS one · 2020Article
- Increase in tympanostomy tube placements despite pneumococcal vaccination, a population-based study.Acta paediatrica (Oslo, Norway : 1992) · 2019Observational
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAntimicrobial resistance is a public-health threat and antimicrobial consumption is the main contributor. The ten-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced into the Icelandic vaccination program in 2011. The aim was to estimate the vaccine impact of PHiD-CV10 on outpatient antimicrobial prescriptions in children.
methodsEleven Icelandic birth-cohorts (2005-2015) were followed from birth until three years of age or to the end of the study period (December 31, 2016). Birth-cohorts were grouped as vaccine non-eligible (VNEC, 2005-2010) or vaccine eligible (VEC, 2011-2015). Data on primary care visits for respiratory infections and antimicrobial prescriptions were extracted from two national registers. Using national identification numbers, prescriptions were linked to physician visits if filled within three days of the visit. Incidence rates and incidence rate ratios between VNEC and VEC were calculated. An Andersen-Gill model was used to model the individual level data, accounting for repeated events and censoring. Vaccine impact was calculated as (1 - Hazard Ratio) × 100%.
resultsIncluded were 53,510 children who contributed 151,992 person-years of follow-up and filled 231,660 antimicrobial prescriptions. The incidence rate was significantly lower in the VEC compared to the VNEC, 144.5 and 157.2 prescriptions per 100 person-years respectively (IRR 0.92, 95%CI 0.91-0.93). Children in VEC were more likely to have filled zero (IRR 1.16 (95%CI 1.10-1.23) and 1-4 (IRR 1.08 95%CI 1.06-1.11) prescriptions compared to children in VNEC. The vaccine impact of PHiD-CV10 against all-cause antimicrobial prescriptions was 5.8% (95%CI 1.6-9.8%).When only considering acute otitis media-associated prescriptions, the vaccine impact was 21.8% (95%CI 11.5-30.9%).
conclusionThe introduction of PHiD-CV10 lead to reduced antimicrobial use in children, mainly by reducing acute otitis media episodes. This intervention therefore reduces both disease burden and could slow the spread of antimicrobial resistance.
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Registered trials
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