Vaccinations Included in the National Immunization Calendar as a Tool to Tackle Antimicrobial Resistance: Current Evidence for Selected Pathogens in Italy.

Background/

Objectives

Antimicrobial (AMR) and antibiotic resistance (AR) remain major growing issues around the world. According to WHO, vaccinations play a strategic role in tackling AMR/AR; the new (upcoming) or existing vaccines (both viral and bacterial) directed toward resistant pathogens, may consistently reduce the overall burden of infectious diseases across the population. The objective of the present work is to review the available evidence on the impact that immunization schedules might exert in terms of antibiotic use reduction, focusing on vaccinations included in the Italian National Immunization Plan (NIP).

Methods

A targeted literature search, limited to 2015-2025, was performed in the PubMed database to identify the available evidence on the impact that vaccinations exert on antibiotic use or reduction.

Results

The search provided evidence on the potential impact that immunizations included in the NIP might exert in tackling AMR/AR. Influenza and pneumococcal vaccinations proved to be those with the broadest base of evidence in reducing antibiotic prescriptions. Preliminary local evidence also suggests an impact on reducing antibiotic use for RSV immunization among adults and older adults. Rotavirus vaccination proved to reduce antibiotic prescriptions, while varicella disease was associated with a relevant use of antibiotics.

Conclusions

Vaccines are essential in the fight against AMR/AR. In this review the evidence on the impact that vaccinations included in the NIP may exert was compacted. The impact of vaccines on reducing AMR/AR should be recognized by Italian stakeholders and strategies and implementation plans should always include vaccines as interventions to reduce AMR/AR.