Associations between private vaccine and antimicrobial consumption across Indian states, 2009–2017

A cross-collaboration among researchers from the US and India has examined the associations between consumption of vaccines and antibiotics from 2009 to 2017 in India’s private health sector to improve understanding of the relationship between vaccines and antibiotic use.

The results indicate vaccine‐induced longer‐term reductions in antibiotic use in India, similar to findings of studies from other low‐ and middle‐income countries where there is a negative relationship between monthly lagged vaccine consumption and monthly antibiotic consumption after 32 months.

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.

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