Vaccines given to young children with antibiotics may reduce protection

United States – According to American researchers who tested the ridiculous response of 560 children aged 6 to 24 months and combined it with prescribed antibiotic treatment, the administration of antibiotics in young children may lead to less vaccine protection.

“Most children are often given antibiotics in the first two years of life, at which time they are vaccinated,” he wrote. Dr. Timothy Chapman (Center for Immunology and Infectious Diseases, Rochester General Hospital Research Institute) and colleagues in the journal Pediatrics[1] .

However, in this study, researchers found that among children receiving antibiotics, titers of vaccine-induced antibodies were generally lower than those thought to be sufficient for immune protection. “Therefore, they are at increased risk of contracting the infection caused by the vaccinated bacterium,” he said. Professor Ulrich SchaibelWho is the head of the infection program at the Borstel Research Center in Leibniz (Germany).

Timothy Chapman and his co-authors explain that potential groups of children were first screened for acute respiratory infections, including acute otitis media. They then pre-analyzed blood samples taken at 6, 9, 12, 15, 18 and 24 months of age and during the onset of acute otitis media.

Antibody responses against 10 antigens of 4 vaccines administered to these children were analyzed. The vaccine was:

  • Against diphtheria-tetanus-pertussis (DTaP),

  • Inactive poliomyelitis (IPV),

  • Haemophilus influenzae type b (Hib) and against it

  • Antipneumococcal Conjugate (PCV).

The researchers compared the measurements with data from medical records and asked about parents’ illnesses and antibiotic prescriptions. Of the 560 children tested, 342 received antibiotics in the first 24 months of life. The most frequently prescribed antibiotics were:

A control group was formed of 218 children who had not been treated with antibiotics.

Titers fall with each administration of antibiotics

The researchers found that the antibody titers of children treated with antibiotics were lower on average than those of children who were not treated with antibiotics. These titers were often below the protective threshold when antibiotic treatment was administered between 9 and 12 months. This was particularly the case with reactions against the DTaP antigen and against pneumococcal serotype 14.

Repeated use of antibiotics has strengthened the negative effects on antibody levels. With each antibiotic treatment, the titers read:

  • 5.8% for DTaP antigen,

  • 6.8% for Hib antigen,

  • 11.3% for IPV antigen,

  • And 10.4% for PCV antigen.

“To find out if a booster vaccine modified this association, we conducted an analysis of antibiotic prescriptions up to 15 months of age,” the authors report. They found that children who received antibiotics always had less ridiculous reactions. Titers were reduced after the vaccine booster:

  • 18.1% for DTaP,

  • 21.3% for Hib,

  • 18.9% for IPV,

  • And 12.2% for mail orders.

Intestinal microbiome may be involved

It has already been described that taking antibiotics may reduce the effectiveness of immunizations, but this study is the first of its kind in young children. It is hypothesized that the phenomenon occurs through the effect on the intestinal microbiome. “The administration of antibiotics to a young child can alter its microbiome, thereby reducing the diversity of the bacterial species present there – even for long periods of time, and especially after prolonged administration of antibiotics,” explains Ulrich Schaibel. This leads to dysbiosis, which has been shown in mouse studies to be not only more susceptible to infection but also to more pronounced inflammatory conditions, which can negatively affect the immune system.

Giving antibiotics to a young child can change their microbiome.
Professor Ulrich Schaibel

Differences in effects between antibiotics

For Ulrich Schবuble, it is interesting to note that amoxicillin alone had no significant effect in this study in contrast to its combination with clavulanic acid: for all vaccine antigens and compared with the absence of antibiotic therapy, the proportion of infants was insufficient. The level of protection with amoxicillin was 16.4% vs. 13.5% without antibiotics (p = 0.22). On the other hand, 19.8% of cases after treatment with amoxicillin / clavulanic acid (OR: 1.58; p <0.001 vs. not taking antibiotics). "Clavulanic acid is a beta-lactamase inhibitor that cleaves beta-lactam antibiotics, such as amoxicillin, ceftriaxone, and cefdinir," explains Ulrich Schবলuble.

Short treatment regimens?

However, the combination of amoxicillin / clavulanic acid has less effect on antibody production after 5 days than administration for 10 days. “Therefore, it would be advisable to give antibiotics for a short period of time,” said Ulrich Schaibel. “We need to develop short but still effective treatment methods and diagnostic methods that can demonstrate the effectiveness of antibiotics in real time so that the duration of their administration can be shortened. A

We need to develop short but still effective treatment methods and diagnostic methods that can indicate the effectiveness of antibiotics in real time.
Professor Ulrich Schaibel

The effects of probiotics should be examined

Administration of probiotics may be another way to limit the effects of antibiotics on the immune system: “By giving probiotics (more precisely bacteria that may be beneficial to intestinal flora), we aim to promote the recovery of intestinal flora”. The Dr. Claudius MeyerHead of the Pediatric Immunology Working Group at the Center for Pediatric Medicine at the University of Mainz.

Limit the use of antibiotics that are strictly necessary

According to the immunologist, the presented study highlights the problematic side effects of antibiotics. Combined with the development of resistance, “These physiological effects should encourage us to use antibiotics with caution and to limit what we strictly need in childhood. A

Ulrich Schবলuble also thinks that probiotics should be tested for a protective effect, adding that another track may be “suspending vaccination during antibiotic therapy, then carrying a catch-up.”

Other vaccines may be needed

Claudius Meyer recalls that “antibodies are only part of the immune response to vaccination. Perhaps it induces T cell-mediated vaccination and the latter provides some protection. This cannot be confirmed on a case-by-case basis. A control at the age of 3 or 5 may be effective in identifying the potential need for a booster. After a reminder, those who took antibiotics could be separated from the control group.

Only a follow-up study with the same children would be able to show whether, after a reminder, those who had taken antibiotics could be separated from the control group.
Dr. Claudius Meyer

This article or section needs sources or references that appear in credible, third-party publications. Schlechter Impfschutz bei Kleinkindern nach Antibiotika-Gabe beobachtet – sollte man dan nachimpfen?

Follow Medscape in French Twitter.

Follow | Medscape Cardiology introduced Twitter.

Leave a Comment