Influence of the Protein-conjugated Pneumococcal Vaccine (PCV7) and the Newly Developed Antimicrobials on the Incidence of Acute Otitis Media and the Frequency of Myringotomy

Abstract

We conducted an epidemiological survey of patients with acute otitis media (AOM) and evaluated the effects of use of the protein-conjugated pneumococcal vaccine (PCV7) and of the newly developed antimicrobials tosufloxacin (TFLX) and tebipenem pivoxil (TBPM-PI) on the incidence of AOM and the frequency of myringotomy in Japan. The 7-year study between 2007 and 2013 was based on the Japan Medical Data Center (JMDC) Claims Database of neonates to children less than 15 years old. The number of AOM patients did not change significantly during the study period. On the other hand, the myringotomy rate showed a significant decline over time after 2010. In Japan, large-scale PCV7 vaccination was started in 2011 under public assistance, and the newly developed antimicrobials TFLX and TBPM-PI were introduced in the market in 2009 and 2010, respectively, before the large-scale PCV7 vaccination initiative was launched. The major antimicrobial agents used for AOM are amoxicillin, cefditoren pivoxil, and amoxicillin clavulanate, and rate of use these drugs did not change during study period. On the other hand, the number of prescriptions for TFLX and TBPM-PI increased over time, and also, the number of prescriptions for these drugs showed a significant negative correlation with the myringotomy rate. Based on this evaluation, while adoption of PCV7 vaccination may not have had a strong influence on the incidence of AOM or the myringotomy rate in Japan, wider use of the newly developed antimicrobials TFLX and TBPM-PI appears to have played an important role in the decline of the myringotomy rate over time.