ArticleThe Journal of infectious diseases2025
Pediatric Antibiotic Use Associated With Respiratory Syncytial Virus and Influenza in the United States, 2008-2018.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundUnderstanding 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.
methodsWe conducted a retrospective study of outpatient antibiotic prescriptions dispensed to children in the Optum Clinformatics DataMart from 2008 to 2018. We used negative binomial time series models regressing weekly antibiotic prescriptions against RSV and influenza circulation measures to estimate counterfactual rates of antibiotic prescriptions in the presence and absence of RSV and influenza circulation overall and by age group, census division, and antibiotic class. We considered syndromic RSV and influenza measures (medical claims) and laboratory measures (National Respiratory and Enteric Virus Surveillance System) and controlled for age, division, 13-valent pneumococcal conjugate vaccine introduction, and seasonal and secular trends.
resultsAn estimated 6.3% (95% CI, 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.
conclusionsRSV and influenza are associated with 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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