TY - JOUR
T1 - The impact of influenza vaccination on antibiotic use in the United States, 2010-2017
AU - Klein, Eili Y.
AU - Schueller, Emily
AU - Tseng, Katie K.
AU - Morgan, Daniel J.
AU - Laxminarayan, Ramanan
AU - Nandi, Arindam
N1 - Funding Information:
Financial support. This work was supported by the Value of Vaccination Research Network (VoVRN) through a grant from the Bill & Melinda Gates Foundation (Grant OPP1158136).
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background. Influenza, which peaks seasonally, is an important driver for antibiotic prescribing. Although influenza vaccination has been shown to reduce severe illness, evidence of the population-level effects of vaccination coverage on rates of antibiotic prescribing in the United States is lacking. Methods. We conducted a retrospective analysis of influenza vaccination coverage and antibiotic prescribing rates from 2010 to 2017 across states in the United States, controlling for differences in health infrastructure and yearly vaccine effectiveness. Using data from IQVIA's Xponent database and the US Centers for Disease Control and Prevention's FluVaxView, we employed fixed-effects regression analysis to analyze the relationship between influenza vaccine coverage rates and the number of antibiotic prescriptions per 1000 residents from January to March of each year. Results. We observed that, controlling for socioeconomic differences, access to health care, childcare centers, climate, vaccine effectiveness, and state-level differences, a 10-percentage point increase in the influenza vaccination rate was associated with a 6.5% decrease in antibiotic use, equivalent to 14.2 (95% CI, 6.0-22.4; P = .001) fewer antibiotic prescriptions per 1000 individuals. Increased vaccination coverage reduced prescribing rates the most in the pediatric population (0-18 years), by 15.2 (95% CI, 9.0-21.3; P < .001) or 6.0%, and the elderly (aged 65+), by 12.8 (95% CI, 6.5-19.2; P < .001) or 5.2%. Conclusions. Increased influenza vaccination uptake at the population level is associated with state-level reductions in antibiotic use. Expanding influenza vaccination could be an important intervention to reduce unnecessary antibiotic prescribing.
AB - Background. Influenza, which peaks seasonally, is an important driver for antibiotic prescribing. Although influenza vaccination has been shown to reduce severe illness, evidence of the population-level effects of vaccination coverage on rates of antibiotic prescribing in the United States is lacking. Methods. We conducted a retrospective analysis of influenza vaccination coverage and antibiotic prescribing rates from 2010 to 2017 across states in the United States, controlling for differences in health infrastructure and yearly vaccine effectiveness. Using data from IQVIA's Xponent database and the US Centers for Disease Control and Prevention's FluVaxView, we employed fixed-effects regression analysis to analyze the relationship between influenza vaccine coverage rates and the number of antibiotic prescriptions per 1000 residents from January to March of each year. Results. We observed that, controlling for socioeconomic differences, access to health care, childcare centers, climate, vaccine effectiveness, and state-level differences, a 10-percentage point increase in the influenza vaccination rate was associated with a 6.5% decrease in antibiotic use, equivalent to 14.2 (95% CI, 6.0-22.4; P = .001) fewer antibiotic prescriptions per 1000 individuals. Increased vaccination coverage reduced prescribing rates the most in the pediatric population (0-18 years), by 15.2 (95% CI, 9.0-21.3; P < .001) or 6.0%, and the elderly (aged 65+), by 12.8 (95% CI, 6.5-19.2; P < .001) or 5.2%. Conclusions. Increased influenza vaccination uptake at the population level is associated with state-level reductions in antibiotic use. Expanding influenza vaccination could be an important intervention to reduce unnecessary antibiotic prescribing.
KW - Antibiotic consumption
KW - Antimicrobial resistance
KW - Ecological study
KW - Influenza vaccination
KW - Upper respiratory tract infections
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U2 - 10.1093/ofid/ofaa223
DO - 10.1093/ofid/ofaa223
M3 - Article
C2 - 32665959
AN - SCOPUS:85090797999
SN - 2328-8957
VL - 7
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 7
M1 - ofaa223
ER -