ArticleThe Journal of clinical investigation2024
Antibiotic use during influenza infection augments lung eosinophils that impair immunity against secondary bacterial pneumonia.
Article in The Journal of clinical investigation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A visualization analysis of Traditional Chinese Medicine for influenza prevention and treatment: advances, hotspots, and future trends.Frontiers in medicine · 2026Pooled it
- The Role of the Respiratory Microbiome in Pneumonia.Clinics in chest medicine · 2026Review
- Potential Non-Specific Benefits of Seasonal Influenza Vaccination: Evidence, Knowledge Gaps, and Future Directions.Vaccines · 2026Review
- Global, regional, and national burden of influenza-associated lower respiratory infections, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021.BMC infectious diseases · 2026Article
- Construction of an auxiliary diagnostic model for secondary pulmonary bacterial infection in influenza based on routine detection indicators.American journal of translational research · 2026Article
- A multi-omics case-control study identifying oropharyngeal microbiome-metabolite patterns that characterize secondary bacterial pneumonia among influenza patients.Frontiers in microbiology · 2026Article
- Association between influenza vaccine effectiveness and chronic diseases among older adults with dementia.Scientific reports · 2025Article
- Comparison of initial empirical antibiotic regimens in severe community-acquired pneumonia: a network meta-analysis.BMC pulmonary medicine · 2025Article
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Authors and funding
26 authors.
Funding
Abstract
A leading cause of mortality after influenza infection is the development of a secondary bacterial pneumonia. In the absence of a bacterial superinfection, prescribing antibacterial therapies is not indicated but has become a common clinical practice for those presenting with a respiratory viral illness. In a murine model, we found that antibiotic use during influenza infection impaired the lung innate immunologic defenses toward a secondary challenge with methicillin-resistant Staphylococcus aureus (MRSA). Antibiotics augment lung eosinophils, which have inhibitory effects on macrophage function through the release of major basic protein. Moreover, we demonstrated that antibiotic treatment during influenza infection caused a fungal dysbiosis that drove lung eosinophilia and impaired MRSA clearance. Finally, we evaluated 3 cohorts of hospitalized patients and found that eosinophils positively correlated with antibiotic use, systemic inflammation, and worsened outcomes. Altogether, our work demonstrates a detrimental effect of antibiotic treatment during influenza infection that has harmful immunologic consequences via recruitment of eosinophils to the lungs, thereby increasing the risk of developing a secondary bacterial infection.
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