朱麗安娜·米蘭達 / 2024 年 10 月 25 日 / Medscape 醫學新聞
擴大疫苗使用有可能每年減少多達 25 億劑抗生素藥物的使用，為對抗全球最大的公共衛生挑戰之一抗生素抗藥性 (AMR) 做出重大貢獻。
這些資訊包含在世界衛生組織（WHO）關於該主題的新報告中，該報告估計了免疫接種率增加的潛在影響。文件強調，疫苗在降低抗生素抗藥性方面的作用尚未被充分認識，儘管疫苗可以「訓練」免疫系統，以便在感染開始或惡化之前更好地防禦各種病原體。
報告指出：「接種疫苗的人感染率會降低，因此也能免受繼發感染帶來的潛在並發症的影響，繼發感染可能會引發使用抗菌藥物或需要入院。」
世衛組織秘書長譚德塞博士強調了實施預防策略的重要性。
「應對抗生素抗藥性首先從預防感染開始，而疫苗是最有力的工具之一」，他說道。他補充說：「預防勝於治療，因此增加現有疫苗的獲取並針對結核病等重大疾病開發新的免疫接種，對於拯救生命和扭轉當前趨勢至關重要。」
研究人員計算了三個主要類別的總體影響：已經存在的疫苗、處於開發最後階段的疫苗以及假設的疫苗。
總共評估了針對 24 種病原體的 44 種疫苗，其中 19 種針對細菌，4 種針對病毒，1 種針對寄生蟲。由於感染可引起不同的綜合症候群並影響不同的年齡組，因此在許多情況下，通常會針對相同病原體評估多種疫苗，以確定它們對抗生素抗藥性的潛在影響。
抗生素抗藥性問題主要是由抗生素的過度使用和濫用所造成的。據估計，AMR 每年導致約 500 萬人死亡。報告稱，增加疫苗的使用可以防止許多死亡，並大幅節省治療成本，並減少因患者生產力下降而造成的經濟損失。
新報告擴展了世界衛生組織 2023 年在《BMJ 全球健康》雜誌上發表的一項研究，該研究顯示了接種疫苗的好處。
研究估計，使用現有的 B 型嗜血桿菌和傷寒沙門氏菌疫苗，每年可預防多達 106,000 例與 AMR 相關的死亡。
透過針對結核分枝桿菌和肺炎克雷伯菌的新疫苗的開發和全球部署，每年可避免另外 543,000 例與 AMR 相關的死亡。
目前，針對結核病病原體的新疫苗已處於臨床試驗階段，針對肺炎克雷伯菌的疫苗正處於開發的早期階段。
處於臨床開發後期階段的疫苗每年可預防多達 135,000 例死亡和 500 萬傷殘調整生命年 (DALY)。此外，它們還可以減少 12 億美元的醫院成本和 22 億美元的生產力損失，所有這些都與 AMR 有關。
對於處於開發早期階段的疫苗來說，潛在影響也很大。它們每年可以避免多達 408,000 人死亡和 2,300 萬傷殘調整生命年 (DALY)，從而節省 300 億美元的醫院費用和 177 億美元的生產力損失。
新報告還提出了一系列建議，例如將疫苗納入對抗抗生素抗藥性的全球和區域策略，以及系統性地審查結果。
文件建議，應加速引進現有疫苗，包括擴大疫苗接種覆蓋率。 「所有現有的兒科疫苗都應達到 IA2030 [免疫議程 2030] 的免疫目標，並且應考慮在較大年齡組中使用疫苗。」
抗生素抗藥性對健康和經濟的嚴重影響正受到越來越多的關注。在最近於9月底舉行的聯合國大會期間，就這一問題舉行了一次高級別會議，並發表了一份政治宣言。
在該文件中，世界領導人承諾採取一系列行動和目標來解決這個問題，概述了增加新藥和疫苗研究經費的目標，以及共同努力加強公共衛生系統的目標。
提出的關鍵亮點之一是到 2030 年籌集 1 億美元的目標，以確保至少 60% 的成員國能夠為其 AMR 作戰計畫提供資金。
這個故事是從 Medscape 的葡萄牙語版本翻譯而來的，作為翻譯過程的一部分，使用了包括人工智慧在內的多種編輯工具。編輯者在發布前審查了該內容。
Medscape 醫學新聞 © 2024 WebMD, LLC
Can Vaccines Slash Global Antibiotic Use? WHO Says Yes
Giuliana Miranda / October 25, 2024 / Medscape Medical News
Expanding vaccine use has the potential to reduce the administration of up to 2.5 billion doses of antimicrobials per year, making a significant contribution to the fight against antimicrobial resistance (AMR), one of the greatest public health challenges worldwide.
This information is included in a new World Health Organization (WHO) report on the subject, which estimated the potential impact of increases in immunization rates. The document emphasized that the role of vaccines in reducing AMR has not been fully recognized, even though vaccines can “train” the immune system to better defend against various pathogens before an infection begins or worsens.
“Vaccinated people will have fewer infections and thus will also be protected against potential complications from secondary infections that may trigger the use of antimicrobials or require admission to hospital,” the report stated.
WHO Director General Tedros Adhanom Ghebreyesus, PhD, highlighted the importance of implementing preventive strategies.
“Tackling AMR starts with infection prevention, and vaccines are among the most powerful tools for this,” he stated. “Prevention is better than cure, so increasing access to available vaccines and developing new immunizations for critical diseases, like tuberculosis, is essential to save lives and reverse the current trend,” he added.
Researchers calculated the total impact across three main categories: Vaccines already in existence, those in the final stages of development, and hypothetical vaccines.
A total of 44 vaccines targeting 24 pathogens were evaluated, including 19 against bacteria, 4 against viruses, and 1 against a parasite. As infections can cause different syndromes and can affect various age groups, in many cases, multiple vaccines were often assessed for the same pathogen to determine their potential impact on AMR.
The problem of AMR has been primarily driven by the overuse and misuse of antibiotics. AMR is estimated to be linked to approximately 5 million deaths annually. According to the report, increasing vaccine use could prevent many of these deaths, as well as bring about significant cost savings in treatment and reduce financial losses due to decreased patient productivity.
The new report expanded on a previous WHO study published in 2023 in BMJ Global Health, which indicated the benefits of implementing vaccines.
The study estimated that the use of existing vaccines against pneumococcal Haemophilus influenzae type B and Salmonella typhi could prevent up to 106,000 AMR-related deaths annually.
Each year, another 543,000 deaths linked to AMR could be avoided with the development and global deployment of new vaccines against Mycobacterium tuberculosis and Klebsiella pneumoniae.
Currently, new vaccines targeting tuberculosis-causing pathogens are already in clinical trial phases, and one against K pneumoniae is in the early stages of development.
Vaccines in the advanced stages of clinical development could prevent up to 135,000 deaths annually and 5 million disability-adjusted life years (DALYs). Additionally, they could reduce hospital costs by $1.2 billion and productivity losses by $2.2 billion, all associated with AMR.
For vaccines in the early stages of development, the potential impacts are also significant. They could prevent up to 408,000 deaths annually and 23 million DALYs, saving $30 billion in hospital costs and $17.7 billion in productivity losses.
The new report also provided a series of recommendations, such as incorporating vaccines into global and regional strategies to combat AMR, as well as systematically reviewing the results.
The document suggested that the introduction of existing vaccines should be accelerated, including expanding vaccination coverage. “All existing pediatric vaccines should reach the immunization targets of IA2030 [Immunization Agenda 2030], and the use of vaccines in older age groups should be considered.”
The severe health and economic impacts of AMR are receiving increasing attention. During the recent United Nations General Assembly held at the end of September, a high-level meeting on the issue concluded with the publication of a political declaration.
In the document, world leaders committed to a set of actions and goals to address the problem, outlining objectives for increasing research funding for new drugs and vaccines, as well as joint efforts to strengthen public health systems.
One of the key highlights presented was the goal of securing $100 million by 2030 to ensure that at least 60% of member countries can finance their AMR combat plans.
This story was translated from Medscape’s Portuguese edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
25
41
Credit
Lead image: Science Photo Library/Getty Images
Medscape Medical News © 2024 WebMD, LLC
Send comments and news tips to news@medscape.net.
Cite this: Can Vaccines Slash Global Antibiotic Use? WHO Says Yes – Medscape – October 25, 2024.