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Review
. 2016 Jun 7;7(3):e00428-16.
doi: 10.1128/mBio.00428-16.

How Can Vaccines Contribute to Solving the Antimicrobial Resistance Problem?

Marc Lipsitch  1 , George R Siber  2
Affiliations
Review

How Can Vaccines Contribute to Solving the Antimicrobial Resistance Problem?

Marc Lipsitch et al. mBio. .

Abstract

There is a growing appreciation for the role of vaccines in confronting the problem of antimicrobial resistance (AMR). Vaccines can reduce the prevalence of resistance by reducing the need for antimicrobial use and can reduce its impact by reducing the total number of cases. By reducing the number of pathogens that may be responsible for a particular clinical syndrome, vaccines can permit the use of narrower-spectrum antibiotics for empirical therapy. These effects may be amplified by herd immunity, extending protection to unvaccinated persons in the population. Because much selection for resistance is due to selection on bystander members of the normal flora, vaccination can reduce pressure for resistance even in pathogens not included in the vaccine. Some vaccines have had disproportionate effects on drug-resistant lineages within the target species, a benefit that could be more deliberately exploited in vaccine design. We describe the effects of current vaccines in controlling AMR, survey some vaccines in development with the potential to do so further, and discuss strategies to amplify these benefits. We conclude with a discussion of research and policy priorities to more fully enlist vaccines in the battle against AMR.

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Figures

FIG 1
FIG 1
Mechanisms by which vaccines can contribute to reducing the prevalence and impact of antimicrobial resistance.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention 2013. Antibiotic resistance threats in the United States, 2013. Centers for Disease Control and Prevention, Atlanta, GA. http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.
    1. Review on Antimicrobial Resistance 2014. Antimicrobial resistance: tackling a crisis for the health and wealth of nations. London, United Kingdom: http://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tac....
    1. White House 2014. National strategy for combating antibiotic-resistant bacteria. The White House, Washington, DC: https://www.whitehouse.gov/sites/default/files/docs/carb_national_strate....
    1. World Health Organization 2015. Global action plan on antimicrobial resistance. World Health Organization, Geneva, Switzerland.
    1. Review on Antimicrobial Resistance 2016. Tackling drug-resistant infections globally: final report and recommendations. London, United Kingdom: http://amr-review.org/sites/default/files/160518_Final%20paper_with%20co....

MeSH terms