ArticleBMC infectious diseases2026
Factors associated with antibiotic initiation and bacterial coinfection in adults with confirmed influenza.
Article in BMC infectious diseases, 2026. 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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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.
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Who cites it
1 citing paper in PubMed.
- Antibiotic Use, Bacterial Co-Infection, and Antimicrobial Resistance in Adults Hospitalized with COVID-19, Influenza, or RSV: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfluenza causes seasonal epidemics worldwide. Bacterial coinfection is a serious complication that, due to diagnostic uncertainty, often results in empirical antibiotic overuse. We aimed to identify clinical and biochemical factors associated with antibiotic initiation and bacterial coinfection in adults with confirmed influenza at the emergency department.
methodsAdult patients presenting to the emergency department with laboratory-confirmed influenza were included across three influenza seasons (2017–2020). Clinical and biochemical data were collected through medical chart review.
resultsA total of 174 influenza-positive patients were included. Independent predictors of antibiotic initiation were clinical scores NEWS2 ≥ 7 (aOR 8.99, 95% CI 2.38–33.96) and CRB-65 ≥ 2 (aOR 13.22, 95% CI 2.70–64.73), as well as biomarkers CRP (aOR 1.57, 95% CI 1.21–2.02), and white blood cell count (aOR 1.25, 95% CI 1.07–1.46). Only CRP was independently associated with bacterial coinfection (aOR 1.47, 95% CI 1.16–1.86). A CRP threshold ≥ 20 mg/L demonstrated 100% sensitivity for detecting bacterial coinfection.
conclusionNEWS2, CRB-65, CRP, and white blood cell count were independently associated with antibiotic initiation in adults with influenza, while only CRP predicted bacterial coinfection. Our findings could improve antibiotic stewardship strategies by underscoring the limited predictive value of clinical scores and the optimal use of biomarkers. CLINICAL TRIAL NUMBER: Not applicable.
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