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Introduction: Combination vaccines improve vaccine uptake and open the infant immunization space for additional vaccines. Hexavalent vaccines have been marketed since 2000. Infanrix hexa (combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b conjugate vaccine, DTPa-HBV-IPV/Hib, GSK) is longest on the market, providing 16 years post-marketing experience. Each DTPa-HBV-IPV/Hib vaccine component is licensed alone and/or in smaller combination vaccines. Programmatic considerations sometimes require an interchange between vaccines due to unavailability, program change or mixed schedules (when the number of required antigens differs across scheduled primary vaccination visits). Areas covered: Immunogenicity and safety data from 11 GSK-sponsored clinical trials support the interchangeability of DTPa-HBV-IPV/Hib within the same vaccines family, and use of DTPa-HBV-IPV/Hib in mixed primary vaccination schedules. Expert commentary: Data show acceptability of interchange of DTPa-HBV-IPV/Hib with other products within the same vaccines family and its use in mixed immunization schedules. This aligns with WHO recommendations that vaccines of the same family from the same manufacturer be used to complete the infant vaccination schedule. Interchangeability and suitability for use in mixed schedules is of interest for policy-makers/providers in the framework of vaccination recommendations as it provides flexibility. Given the complexity of larger combination vaccines, interchangeability or sequential use needs careful assessment. [ABSTRACT FROM AUTHOR]

Introduction: The development of diphtheria-tetanus-acellular pertussis-Haemophilus influenzaetype b (Hib) conjugate vaccine combinations culminated with hexavalent vaccines, the largest, most complex vaccine combinations in the immunization calendar. Hexavalent vaccines are used widely in Europe and are co-administered with multiple other recommended vaccines. Hib immunogenicity may reduce when combined with acellular pertussis antigens, or in some co-administrations. We reviewed the epidemiology ofH. influenzaedisease in Europe aiming to evaluate the current level of Hib control and indirectly assess the effectiveness against Hib of GSK’s hexavalent vaccine in 10 countries where it is/has been used almost exclusively. Areas covered: We reviewed surveillance data from the European Union Invasive Bacterial Infections Surveillance Network and the European Surveillance System database from 1999–2014 and extracted case and incidence/notification rates (per 100,000 population) of invasiveH. influenzaedisease. We included age and serotype/strains distribution among countries in the European Union/European Economic Area region that reported to the European Centre for Disease Prevention and Control surveillance system. Expert commentary: The impact of Hib vaccination in Europe is sustained, testifying to continued effectiveness against invasive Hib disease after the implementation of hexavalent vaccines into immunization programs, which, since 2006, has been almost exclusively GSK´s hexavalent DTPa-HBV-IPV/Hib vaccine. [ABSTRACT FROM PUBLISHER]

Background: Antibiotic consumption is one of the main causes of bacterial resistance to antibiotics and a major public health problem worldwide, especially in France. A national campaign was implemented in 2001 to reduce the inappropriate use of antibiotics in France, and guidelines for the management of respiratory tract infections were published in 2005. Methods: In this study, data on paediatric outpatient antibiotic use in France between 2000 and 2010 were derived from prescribing panels of the Permanent Survey of Medical Prescription, which analyzed prescriptions by 835 French general practitioners and specialists. Results: Overall, antibiotic prescriptions decreased by 57.2% between 2001 and 2010 in children aged 0-24 months, by 50.0% in children aged 25 months to 6 y, and by 45.8% in children older than 6 y of age. In the 3 age groups, the greatest reduction was for rhinopharyngitis (83.4%) and the lowest was for otitis (22.4%). Because otitis is one of the most common diseases in childhood, the proportion of antibiotic prescriptions due to otitis in children aged 0-24 months consequently increased from 22.5% in 2000 to 42.3% in 2010. Conclusion: Additional measures may be necessary to decrease antibiotic consumption related to otitis in young children. [ABSTRACT FROM AUTHOR]