Associations between private vaccine and antimicrobial consumption across Indian states, 2009–2017. Issue 1 (5th February 2021)

• Record Type: Journal Article
• Authors: Schueller, Emily; Nandi, Arindam; Joshi, Jyoti; Laxminarayan, Ramanan; Klein, Eili Y.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1494:Issue 1(2021)
• Page Start: 31
• Page End: 43
• Publication Date: 2021-02-05
• Subjects: India -- vaccine -- antibiotic use -- antimicrobial use -- antimicrobial resistance -- AMR; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.14571
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: Vaccines can reduce antibiotic use and, consequently, antimicrobial resistance by averting vaccine‐preventable and secondary infections. We estimated the associations between private vaccine and antibiotic consumption across Indian states during 2009–2017 using monthly and annual consumption data from IQVIA and employed fixed‐effects regression and the Arellano–Bond Generalized Method of Moments (GMM) model for panel data regression, which controlled for income and public sector vaccine use indicators obtained from other sources. In the annual data fixed‐effects model, a 1% increase in private vaccine consumption per 1000 under‐5 children was associated with a 0.22% increase in antibiotic consumption per 1000 people ( P < 0.001). In the annual data GMM model, a 1% increase in private vaccine consumption per 1000 under‐5 children was associated with a 0.2% increase in private antibiotic consumption ( P < 0.001). In the monthly data GMM model, private vaccine consumption was negatively associated with antibiotic consumption when 32, 34, 35, and 44–47 months had elapsed after vaccine consumption, with a positive association with lags of fewer than 18 months. These results indicate vaccine‐induced longer‐term reductions in antibiotic use in India, similar to findings of studies from other low‐ and middle‐income countries. Abstract : The link between vaccines and reductions in antibiotic use is an emerging research area. In the United States and France, studies have found a reduction in antibiotic use associated with introduction of the seven‐valent pneumococcal conjugate vaccine. To improve understanding of the relationship between vaccines and antibiotic use, we examined the associations between consumption of vaccines and antibiotics from 2009 to 2017 in the private health sector in India, which has a lower.