气候变化领域集成服务门户(CCPortal): Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China

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DOI	10.1073/pnas.2004933118
	Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China
	Lu E.; Chen H.-H.; Zhao H.; Ozawa S.
发表日期	2021
ISSN	00278424
卷号	118 期号:13
英文摘要	Antimicrobial resistance (AMR) poses a serious threat to global public health. However, vaccinations have been largely undervalued as a method to hinder AMR progression. This study examined the AMR impact of increasing pneumococcal conjugate vaccine (PCV) coverage in China. China has one of the world’s highest rates of antibiotic use and low PCV coverage. We developed an agent-based DREAMR (Dynamic Representation of the Economics of AMR) model to examine the health and economic benefits of slowing AMR against commonly used antibiotics. We simulated PCV coverage, pneumococcal infections, antibiotic use, and AMR accumulation. Four antibiotics to treat pneumococcal diseases (penicillin, amoxicillin, third-generation cephalosporins, and meropenem) were modeled with antibiotic utilization, pharmacokinetics, and pharmacodynamics factored into predicting AMR accumulation. Three PCV coverage scenarios were simulated over 5 y: 1) status quo with no change in coverage, 2) scaled coverage increase to 99% in 5 y, and 3) accelerated coverage increase to 85% over 2 y followed by 3 y to reach 99% coverage. Compared to the status quo, we found that AMR against penicillin, amoxicillin, and third-generation cephalosporins was significantly reduced by 6.6%, 10.9%, and 9.8% in the scaled scenario and by 10.5%, 17.0%, and 15.4% in the accelerated scenario. Cumulative costs due to AMR, including direct and indirect costs to patients and caretakers, were reduced by $371 million in the scaled and $586 million in the accelerated scenarios compared to the status quo. AMR-reducing benefits of vaccines are essential to quantify in order to drive appropriate investment. © 2021 National Academy of Sciences. All rights reserved.
英文关键词	Antibiotic resistance; China; Immunization; Pneumonia; Vaccine
语种	英语
scopus关键词	amoxicillin; cephalosporin derivative; meropenem; penicillin derivative; Pneumococcus vaccine; antibiotic resistance; Article; child; China; controlled study; cost control; drug efficacy; health economics; health impact assessment; human; infant; infection prevention; newborn; prediction; priority journal; Streptococcus pneumonia; vaccine failure
来源期刊	Proceedings of the National Academy of Sciences of the United States of America
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/180110
作者单位	Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China; Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
推荐引用方式 GB/T 7714	Lu E.,Chen H.-H.,Zhao H.,et al. Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China[J],2021,118(13).
APA	Lu E.,Chen H.-H.,Zhao H.,&Ozawa S..(2021).Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China.Proceedings of the National Academy of Sciences of the United States of America,118(13).
MLA	Lu E.,et al."Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China".Proceedings of the National Academy of Sciences of the United States of America 118.13(2021).