Evidence map›Paper›PMID 39969100›Full record

ArticleThe Journal of antimicrobial chemotherapy2025

General practice antibiotic prescriptions attributable to respiratory syncytial virus by age and antibiotic class: an ecological analysis of the English population.

Lucy Miller, Thomas Beaney, Russell Hope, Mark Cunningham, Julie V Robotham, Koen B Pouwels, Cèire E Costelloe

Abstract read
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In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lucy MillerGlobal Digital Health Unit, School of Public Health, Imperial College London, London W12 0BZ, UK.ORCID 0000-0003-3302-8379
Thomas BeaneyGlobal Digital Health Unit, School of Public Health, Imperial College London, London W12 0BZ, UK.ORCID 0000-0001-9709-7264
Russell HopeHealthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis Division, UK Health Security Agency, London NW9 5EQ, UK.ORCID 0000-0003-2838-6833
Mark CunninghamDepartment of Primary Care and Public Health, School of Public Health, Imperial College London, London W12 0BZ, UK.
Julie V RobothamHealthcare Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Usage and Sepsis Division, UK Health Security Agency, London NW9 5EQ, UK.
Koen B PouwelsThe National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford, Oxford, UK.
Cèire E CostelloeGlobal Digital Health Unit, School of Public Health, Imperial College London, London W12 0BZ, UK.

Funding

Healthcare Associated Infections and Antimicrobial ResistanceInstitute of Cancer Research Biomedical Research CentreMedical Research Foundation National PhD Training Programme in Antimicrobial Resistance Research MRF-145-0004-TPG-AVISONational Institute for Health and Care Research (NIHR) Royal MarsdenNational Institute for Health Research Health Protection Research UnitNational Institute for Health Research Health Protection Research Unit (NIHR HPRU)NIHR 2016-10-95UK Health Security Agency (UKHSA) NIHR200915University of OxfordWellcome Trust
6 · The paper itself

Abstract

backgroundRespiratory syncytial virus (RSV) may contribute to a substantial volume of antibiotic prescriptions in primary care. However, data on the type of antibiotics prescribed for such infections are only available for children <5 years in the UK. Understanding the contribution of RSV to antibiotic prescribing would facilitate predicting the impact of RSV preventative measures on antibiotic use and resistance. The objective of this study was to estimate the proportion of antibiotic prescriptions in English general practice attributable to RSV by age and antibiotic class.

methodsGeneralized additive models examined associations between weekly counts of general practice antibiotic prescriptions and laboratory-confirmed respiratory infections from 2015 to 2018, adjusting for temperature, practice holidays and remaining seasonal confounders. We used general practice records from the Clinical Practice Research Datalink and microbiology tests for RSV, influenza, rhinovirus, adenovirus, parainfluenza, human metapneumovirus, Mycoplasma pneumoniae and Streptococcus pneumoniae from England's Second Generation Surveillance System.

resultsAn estimated 2.1% of antibiotics were attributable to RSV, equating to an average of 640 000 prescriptions annually. Of these, adults ≥75 years contributed to the greatest volume, with an annual average of 149 078 (95% credible interval: 93 733-206 045). Infants 6-23 months had the highest average annual rate at 6580 prescriptions per 100 000 individuals (95% credible interval: 4522-8651). Most RSV-attributable antibiotic prescriptions were penicillins, macrolides or tetracyclines. Adults ≥65 years had a wider range of antibiotic classes associated with RSV compared with younger age groups.

conclusionsInterventions to reduce the burden of RSV, particularly in older adults, could complement current strategies to reduce antibiotic use in England.

Indexed as

Anti-Bacterial AgentsDrug PrescriptionsGeneral PracticeRespiratory Syncytial Virus InfectionsRespiratory Tract InfectionsAdolescentAdultAgedAged, 80 and overAge FactorsChildChild, PreschoolEnglandFemaleHumansInfantAnti-Bacterial Agents

Identifiers

PMID39969100
PMCPMC11962385

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Registered trials

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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.