To estimate the proportions and incidence of outpatient antibiotic prescriptions associated with RSV and influenza infections in commercially insured US children, highlighting the implications for antibiotic stewardship.
Key Findings:
6.3% (95% CI, 5.2%–7.3%) of antibiotic prescriptions were associated with RSV.
3.4% (95% CI, 3.1%–3.8%) of antibiotic prescriptions were associated with influenza.
Annual rates were estimated at 72.6 (59.7–85.9) RSV-associated and 40.0 (35.1–45.1) influenza-associated antibiotic prescriptions per 1000 children.
RSV-associated prescriptions were highest in children ≤5 years, while influenza-associated prescriptions peaked in children >5 years.
Macrolides accounted for the greatest share of antibiotic prescriptions linked to RSV and influenza.
Interpretation:
RSV and influenza significantly contribute to pediatric antibiotic prescriptions, suggesting that preventive measures like vaccination could reduce unnecessary antibiotic use and combat antibiotic resistance, thereby improving public health outcomes.
Limitations:
Study limited to commercially insured children, potentially affecting generalizability to uninsured or publicly insured populations.
Sparse diagnostic testing for RSV and influenza in outpatient settings complicates attribution of antibiotic use, which may lead to underestimation of the true impact.
Conclusion:
Preventive strategies against RSV and influenza, including immunization, may help reduce pediatric antibiotic prescriptions and mitigate antibiotic resistance, emphasizing the need for targeted public health initiatives.
