SynthesisAntimicrobial resistance and infection control2023
The impact of influenza and pneumococcal vaccination on antibiotic use: an updated systematic review and meta-analysis.
Synthesis in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Effectiveness of pneumococcal vaccination in reducing hospitalization and mortality among the elderly: A systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2025Pooled it
- Health-related quality of life and adverse events during 14 days after receiving a live-attenuated influenza vaccine in Japanese children 4-15 years of age.Human vaccines & immunotherapeutics · 2026Article
- Live Attenuated Influenza Vaccine (LAIV) for Children for the Prevention of Influenza Illness in Sweden: A Cost-Effectiveness Analysis.Infectious diseases and therapy · 2026Article
- Combating antimicrobial resistance in Asia: A comprehensive review of strategic action plans, policies, and the role of the WHO.Saudi medical journal · 2025Review
- Review
- COVID-19 vaccination and use of antibiotics in COVID-19 patients: a systematic review and meta-analysis.Infection prevention in practice · 2025Review
- The Central Importance of Vaccines to Mitigate the Threat of Antibiotic-Resistant Bacterial Pathogens.Vaccines · 2025Review
- Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?BMC infectious diseases · 2025Article
- Mapping the role of vaccines in combating AMR in the WHO African region: a scoping review and implications for research and policy.BMC infectious diseases · 2025Article
- Observational study of antibiotic prescribing patterns by age and sex in primary care in England: why we need to take this variation into account to evaluate antibiotic stewardship and predict AMR variation.JAC-antimicrobial resistance · 2025Article
- Temporal trends in vaccination and antibiotic use among young children in the United States, 2000-2019.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Effectiveness of influenza vaccine among the population in Chongqing, China, 2018-2022: A test negative design-based evaluation.Human vaccines & immunotherapeutics · 2024Observational
- Incidence of Influenza-related Medical Encounters and the Associated Healthcare Resource Use and Complications Across Adult Age Groups in the United States During the 2015-2020 Influenza Seasons.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Echinacea Reduces Antibiotics by Preventing Respiratory Infections: A Meta-Analysis (ERA-PRIMA).Antibiotics (Basel, Switzerland) · 2024Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVaccination can prevent bacterial and viral infections that could otherwise increase the chances of receiving (unnecessary) antibiotic treatment(s). As a result, vaccination may provide an important public health intervention to control antimicrobial resistance (AMR).
objectivesPerform a systematic literature review to better understand the impact of influenza, pneumococcal and COVID-19 vaccination on antibiotic use, and to identify differences in effect between world regions and study designs.
methodsWe performed a systematic literature review and meta-analysis which updated previous literature reviews with new data from 1 October 2018 to 1 December 2021. The study focuses on randomised controlled trials (RCTs) and observational studies. Results from the meta-analysis of RCTs were stratified by WHO region and age group. Vote counting based on the direction of effect was applied to synthesize the results of the observational studies.
resultsMost studies are performed in the WHO European Region and the Region of the Americas in high-income countries. RCTs show that the effect of influenza vaccination on the number of antibiotic prescriptions or days of antibiotic use (Ratio of Means (RoM) 0.71, 95% CI 0.62-0.83) is stronger compared to the effect of pneumococcal vaccination (RoM 0.92, 95% CI 0.85-1.00). These studies also confirm a reduction in the proportion of people receiving antibiotics after influenza vaccination (Risk Ratio (RR) 0.63, 95% CI 0.51-0.79). The effect of influenza vaccination in the European and American regions ranged from RoM 0.63 and 0.87 to RR 0.70 and 0.66, respectively. The evidence from observational studies supports these findings but presents a less consistent picture. No COVID-19 studies were identified.
conclusionWe find that both RCTs and observational studies show that influenza vaccination significantly reduces antibiotic use, while the effect of pneumococcal vaccination is less pronounced. We were unable to study the effect of COVID-19 vaccination and no clear regional patterns were found due to the high heterogeneity between studies. Overall, our data supports the use of influenza vaccination as an important public health intervention to reduce antibiotic use and possibly control AMR.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.