TY - JOUR
T1 - The impact of pneumococcal conjugate vaccine on ceftriaxone consumption in the community among young children
AU - Danino, Dana
AU - van der Beek, Bart Adriaan
AU - Greenberg, David
AU - Ben-Shimol, Shalom
AU - Dagan, Ron
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Objectives: Following pneumococcal conjugate vaccine (PCV) introduction, community pediatric dispensed prescription rates (DPR) of oral antibiotics declined, in parallel to respiratory tract infection (RTI). We assessed the dynamics of outpatient parenteral ceftriaxone DPR. Methods: Computerized data for children <5 years were examined during 13 years (including 4 pre-PCV years). DPR from clinics with ≥50 insured children, active both before and after PCV implementation were included. Interrupted time series with segmented regression stratified by age and ethnicity, and adjusted for seasonality was applied to show monthly DPR trends. Results: A total of 29,226 prescriptions were dispensed. No significant trends in ceftriaxone DPR were seen pre-PCV. Shortly after PCV implementation, DPR abruptly and significantly declined, stabilizing in late-PCV period (5 years postimplementation). The dynamics were compared between the two ethnic groups in the region, Jewish and Bedouin children (the latter with higher crowding and respiratory disease rates). Among Jewish children, ceftriaxone was mainly dispensed during winter vs no seasonality among Bedouin children. Conclusions: In southern Israel, outpatient ceftriaxone DPR declined post-PCV in young children, similar to the trends of RTIs and oral antibiotic prescriptions, suggesting a causative role of PCVs. The differences between the two ethnic groups suggest possible involvement of additional factors.
AB - Objectives: Following pneumococcal conjugate vaccine (PCV) introduction, community pediatric dispensed prescription rates (DPR) of oral antibiotics declined, in parallel to respiratory tract infection (RTI). We assessed the dynamics of outpatient parenteral ceftriaxone DPR. Methods: Computerized data for children <5 years were examined during 13 years (including 4 pre-PCV years). DPR from clinics with ≥50 insured children, active both before and after PCV implementation were included. Interrupted time series with segmented regression stratified by age and ethnicity, and adjusted for seasonality was applied to show monthly DPR trends. Results: A total of 29,226 prescriptions were dispensed. No significant trends in ceftriaxone DPR were seen pre-PCV. Shortly after PCV implementation, DPR abruptly and significantly declined, stabilizing in late-PCV period (5 years postimplementation). The dynamics were compared between the two ethnic groups in the region, Jewish and Bedouin children (the latter with higher crowding and respiratory disease rates). Among Jewish children, ceftriaxone was mainly dispensed during winter vs no seasonality among Bedouin children. Conclusions: In southern Israel, outpatient ceftriaxone DPR declined post-PCV in young children, similar to the trends of RTIs and oral antibiotic prescriptions, suggesting a causative role of PCVs. The differences between the two ethnic groups suggest possible involvement of additional factors.
KW - Ceftriaxone Consumption, Community, Children
KW - Pneumococcal Conjugate Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85168602904&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2023.08.002
DO - 10.1016/j.ijid.2023.08.002
M3 - Article
C2 - 37567556
AN - SCOPUS:85168602904
SN - 1201-9712
VL - 135
SP - 21
EP - 27
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -