ArticlemedRxiv : the preprint server for health sciences2025
Pediatric antibiotic use associated with respiratory syncytial virus and influenza in the United States, 2008-2018.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Understanding of the contributions of respiratory syncytial virus (RSV) and influenza infections to pediatric antibiotic use is limited. We aimed to estimate the proportions and incidence of outpatient antibiotic prescriptions associated with RSV and influenza infections in a sample of commercially-insured US children. Methods: We conducted a retrospective study of outpatient antibiotic prescriptions dispensed to children in the Optum Clinformatics Results: An estimated 6.3% (95% confidence interval 5.2-7.3%) and 3.4% (3.1-3.8%) of antibiotic prescriptions were associated with RSV and influenza, respectively. These estimates translate to 72.6 (59.7-85.9) RSV-associated and 40.0 (35.1-45.1) influenza-associated antibiotic prescriptions per 1000 children annually. RSV-associated antibiotic prescription incidence was highest among children aged ≤5 years while influenza-associated antibiotic prescriptions were highest among children >5 years. Macrolides were the antibiotic class for which RSV and influenza accounted for the greatest share of prescribing. Conclusions: RSV and influenza account for meaningful proportions of pediatric antibiotic prescriptions. Measures to prevent RSV and influenza infections in children, including immunization, may reduce antibiotic use and aid in mitigating antibiotic resistance.
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