Editor’s Commentary: Vaccines as a Tool to Combat Antibiotic Resistance

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Infections due to resistant and multiply resistant organisms are an increasing threat to public health worldwide. The dearth of new antibiotics to address this threat has required clinicians to utilize second-line antibiotics or, in some cases, left them without any available therapeutic modality. In contrast to the picture for antibiotics, technologies available to develop new vaccines have expanded dramatically in the past 2 decades. However, the potential for newer vaccines to address the issue of antibiotic-resistant infections has largely gone unrecognized. In this issue, Arto Palmu et al report a 17.5% reduction in antibiotic prescribing for otitis media with higher reductions observed for second-line antibiotics after the introduction of pneumococcal conjugate vaccine in Finland. Because otitis media is the most common cause of antibiotic use in children and because such usage inevitably promotes antibiotic resistance, routine pneumococcal conjugate vaccine immunization should decrease antibiotic resistance. This impact is in addition to the direct effect of pneumococcal conjugate vaccines in virtually eliminating the circulation of many antibiotic-resistant strains. Studies such as this one should encourage strategies to develop new vaccines that specifically target the public health threat posed by multiply resistant bacteria.
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