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The role of vaccines in combatting antimicrobial resistance

Nature Reviews Microbiology volume 19, pages 287–302 (2021)Cite this article

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Abstract

The use of antibiotics has enabled the successful treatment of bacterial infections, saving the lives and improving the health of many patients worldwide. However, the emergence and spread of antimicrobial resistance (AMR) has been highlighted as a global threat by different health organizations, and pathogens resistant to antimicrobials cause substantial morbidity and death. As resistance to multiple drugs increases, novel and effective therapies as well as prevention strategies are needed. In this Review, we discuss evidence that vaccines can have a major role in fighting AMR. Vaccines are used prophylactically, decreasing the number of infectious disease cases, and thus antibiotic use and the emergence and spread of AMR. We also describe the current state of development of vaccines against resistant bacterial pathogens that cause a substantial disease burden both in high-income countries and in low- and medium-income countries, discuss possible obstacles that hinder progress in vaccine development and speculate on the impact of next-generation vaccines against bacterial infectious diseases on AMR.

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Fig. 1: Effects of vaccines on antimicrobial resistance.
Fig. 2: Mechanisms of action of antibiotics and vaccines and emergence of resistance.
Fig. 3: Vaccine development for antimicrobial-resistant pathogens.

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Authors and Affiliations

  1. GSK Vaccines Institute for Global Health, Siena, Italy

    Francesca Micoli

  2. GSK, Siena, Italy

    Fabio Bagnoli, Rino Rappuoli & Davide Serruto

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F.M., F.B. and D.S. researched data for the article and wrote the article. All authors substantially contributed to the discussion of the content, and reviewed and edited the manuscript before submission.

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Correspondence to Rino Rappuoli.

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Competing interests

F.M., F.B., R.R. and D.S. are employees of the GSK group of companies, which is involved in the discovery and commercialization of vaccines and therapeutics against bacterial infections.

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Nature Reviews Microbiology thanks K. Atkins and S. Vong for their contribution to the peer review of this work.

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Related links

AMR Action Fund: https://amractionfund.com

CDC: https://www.cdc.gov/hai/patientsafety/ar-hospitals.html

FAO Global Forum on Food Security and Nutrition: http://www.fao.org/3/cb0863en/cb0863en.pdf

Institute for Health Metrics and Evaluation: http://www.healthdata.org/gbd

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Micoli, F., Bagnoli, F., Rappuoli, R. et al. The role of vaccines in combatting antimicrobial resistance. Nat Rev Microbiol 19, 287–302 (2021). https://doi.org/10.1038/s41579-020-00506-3

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