Nature 581, 94–99 (2020)
Prevalent usage of antibiotics worldwide has resulted in the selection for multidrug-resistant microbes. This scenario makes it increasingly difficult to treat common infectious diseases. In Nature, Lewnard and colleagues report on how childhood vaccination reduced the incidence of antibiotic usage in low-to-middle-income countries. Their retrospective study looked at children under 5 years of age who had been vaccinated or not against Streptococcus pneumoniae and rotavirus, which are causal agents of acute respiratory infection and diarrhea, respectively. They report that children who were vaccinated have lower odds of requiring antibiotic treatment as compared to unvaccinated children of similar age. Indeed, the authors estimate that between 20 and 25% of the children receiving antibiotics for diarrhea or pneumonia had infections that were attributable to the vaccine-targeted infectious agents. Further, they suggest that universal vaccine coverage against these two infectious agents would prevent 40 million cases of children requiring antibiotic treatment. This study makes another compelling case for the benefits of vaccination.