Antibiotic use attributable to RSV infections during infancy-an international prospective birth cohort study
Hak, Sarah F Venekamp, Roderick P Billard, Marie-Noƫlle Cianci, Daniela van Houten, Marlies A Pollard, Andrew J Heikkinen, Terho Cunningham, Steve Millar, Margaret Martinon-Torres, Federico
Hak, Sarah F
Venekamp, Roderick P
Billard, Marie-Noƫlle
Cianci, Daniela
van Houten, Marlies A
Pollard, Andrew J
Heikkinen, Terho
Cunningham, Steve
Millar, Margaret
Martinon-Torres, Federico
Series / Report no.
Open Access
Type
Journal Article
Multicenter Study
Observational Study
Article
Multicenter Study
Observational Study
Article
Language
en
Date of publication
2025-07-01
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Antibiotic use attributable to RSV infections during infancy-an international prospective birth cohort study
Translated Title
Published in
J Antimicrob Chemother 2025; 80(7):1803-1812
Abstract
Early-life antibiotic use impacts microbiome composition and contributes to the emergence of antimicrobial resistance. Despite respiratory syncytial virus (RSV) being a leading cause of acute respiratory infections (ARI), accurate estimates of antibiotic use attributable to RSV are lacking.
To assess RSV-associated antibiotic use during the first year of life.
The RESCEU birth cohort study followed healthy term infants, born (nā=ā9154) between 1 July 2017 and 31 July 2020 from five European countries, to identify RSV-ARI hospitalizations during infancy. In a nested cohort (nā=ā993), we performed active RSV surveillance by collecting nasal swabs in case of ARI symptoms during RSV seasons (October-April). Antibiotic use during hospitalization was identified through chart review, while outpatient data were collected via parental questionnaires.
In the total cohort, antibiotics were used in 22.8% of RSV hospitalizations (33/145) and 62.5% of RSV intensive care admissions (5/8). In the nested cohort, antibiotics were used in 5.2% of any-severity RSV-ARI (13/250) and 9.9% of medically attended RSV-ARI (13/131). This results in an estimated incidence of 1.3% (95%CI: 0.8-2.0) of healthy term infants receiving ā„1 course of antibiotics associated with RSV infection in their first year, with an incidence rate of 1.1 RSV-associated antibiotic prescriptions per 1000 infant-months (95%CI: 0.6-1.9). As such, RSV accounts for 22.9% of antibiotic prescriptions for ARI during RSV seasons.
One in 77 healthy term infants receives antibiotics during RSV infection before their first birthday. Real-world evidence is needed to establish the impact of RSV immunization on antibiotic use during infancy.
NCT03627572.
To assess RSV-associated antibiotic use during the first year of life.
The RESCEU birth cohort study followed healthy term infants, born (nā=ā9154) between 1 July 2017 and 31 July 2020 from five European countries, to identify RSV-ARI hospitalizations during infancy. In a nested cohort (nā=ā993), we performed active RSV surveillance by collecting nasal swabs in case of ARI symptoms during RSV seasons (October-April). Antibiotic use during hospitalization was identified through chart review, while outpatient data were collected via parental questionnaires.
In the total cohort, antibiotics were used in 22.8% of RSV hospitalizations (33/145) and 62.5% of RSV intensive care admissions (5/8). In the nested cohort, antibiotics were used in 5.2% of any-severity RSV-ARI (13/250) and 9.9% of medically attended RSV-ARI (13/131). This results in an estimated incidence of 1.3% (95%CI: 0.8-2.0) of healthy term infants receiving ā„1 course of antibiotics associated with RSV infection in their first year, with an incidence rate of 1.1 RSV-associated antibiotic prescriptions per 1000 infant-months (95%CI: 0.6-1.9). As such, RSV accounts for 22.9% of antibiotic prescriptions for ARI during RSV seasons.
One in 77 healthy term infants receives antibiotics during RSV infection before their first birthday. Real-world evidence is needed to establish the impact of RSV immunization on antibiotic use during infancy.
NCT03627572.