Antibiotic use attributable to RSV infections during infancy—an international prospective birth cohort study

作者：Sarah F. Hak, Roderick P Venekamp, Marie‐Noëlle Billard, Daniela Cianci, Marlies A. van Houten, Andrew J. Pollard, Terho Heikkinen, Steve Cunningham, Margaret Millar, Federico Martinón‐Torres, Ana Dacosta-Urbieta, Louis Bont, Joanne Wildenbeest, PROMISE Investigators, Sarah Hak, Roderick P Venekamp, Joanne Wildenbeest, Marie‐Noëlle Billard, Marlies van Houten, Louis Bont, Andrew J. Pollard, Ana Dacosta-Urbieta, Federico Martinón‐Torres, Terho Heikkinen, Steve Cunningham, Harish Nair, Margaret A. Miller, Peter Openshaw, Philippe Beutels, Hannah Nohynek, Anne Teirlinck, Christos Baliatsas, Leyla Kragten, Thea Fisher, Carlo Giaquinto, Javier Díez‐Domingo, Rafael Mikolajczyk, Jim Jamaniak, Elizabeth Begier, Jenny Hendri, Rolf Kramer, Veena Kumar, Bahar Ahani, Eva Molero · 发表于：Journal of Antimicrobial Chemotherapy · 年份：2025 · DOI：10.1093/jac/dkaf123 · 被引用次数：4 · 研究领域：Respiratory viral infections research、Neonatal and Maternal Infections、Antibiotic Use and Resistance

BACKGROUND: 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. OBJECTIVES: To assess RSV-associated antibiotic use during the first year of life. PATIENTS AND METHODS: The RESCEU birth cohort study followed healthy term infants, born (n = 9154) between 1 July 2017 and 31 July 2020 from five European countries, to identify RSV-ARI hospitalizations during infancy. In a nested cohort (n = 993), 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. RESULTS: 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 ≥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 an...