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Updated: May 12, 2025
An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Antibiotic use attributable to RSV infections during infancy-an international prospective birth cohort study
Sarah F Hak1, Roderick P Venekamp2, Marie-Noëlle Billard1
1Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Approximately 1.3% of infants receive antibiotics for respiratory syncytial virus (RSV) infections within their first year. This highlights the significant impact of RSV on early-life antibiotic exposure and antimicrobial resistance.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Early-life antibiotic exposure influences microbiome development and antimicrobial resistance.
- Respiratory Syncytial Virus (RSV) is a major cause of infant acute respiratory infections (ARIs).
- Data on antibiotic use specifically linked to RSV in infants is limited.
Purpose of the Study:
- To quantify antibiotic use associated with RSV infections in infants during their first year of life.
Main Methods:
- A prospective birth cohort study (RESCEU) followed 9154 infants across five European countries.
- Active RSV surveillance with nasal swabs was conducted in a nested cohort of 993 infants during RSV seasons.
- Antibiotic use was documented via medical chart review for hospitalizations and parental questionnaires for outpatient care.
Main Results:
- Antibiotics were used in 22.8% of RSV hospitalizations and 62.5% of RSV intensive care admissions.
- In the nested cohort, 5.2% of all RSV-ARIs and 9.9% of medically attended RSV-ARIs received antibiotics.
- An estimated 1.3% of healthy term infants received antibiotics for RSV infection in their first year, accounting for 22.9% of ARI antibiotic prescriptions during RSV seasons.
Conclusions:
- One in 77 healthy infants receives antibiotics for RSV infection before age one.
- Further research on RSV immunization's impact on infant antibiotic use is warranted.
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 antibiotic prescriptions for ARI during RSV seasons.
Conclusions:
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.
Clinical Trials Registration:
NCT03627572.
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