Antibiotic resistance and the potential impact of pneumococcal conjugate vaccines.

Streptococcus pneumoniae is a major cause of morbidity and mortality in young children throughout the world, causing both invasive (meningitis, bacteraemia) and non-invasive (pneumonia, acute otitis media, sinusitis) infections. Over the past few decades, the global emergence of antibiotic-resistant pneumococcal strains has complicated disease management. Thus, healthcare practitioners have begun to place more emphasis on the judicious use of antibiotics and prevention of disease through routine immunisation. Researchers have developed several pneumococcal conjugate vaccines, which due to their technology, are effective in infants and young children. Currently, one 7-valent pneumococcal conjugate vaccine (PNCRM7; Prevenar, Wyeth) is available in various parts of the world and has demonstrated excellent efficacy against vaccine-type invasive disease and efficacy against pneumonia and otitis media caused by the serotypes included in the vaccine. Furthermore, there is evidence suggesting that the use of these conjugate vaccines will reduce the need for antibiotics and the subsequent spread of antibiotic-resistant pneumococci. Ultimately, when routine pneumococcal conjugate vaccination of infants and young children is accompanied by supportive education and active disease surveillance as well as judicious use of antibiotics, there should be a favourable impact on pneumococcal disease incidence in and beyond the vaccinated population.