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Updated: May 28, 2026

An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
09:01

An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection

Published on: December 10, 2013

Exploring the Link Between RSV Infection and Antibiotic Prescriptions in Older Adults: A Systematic Review

Farzaneh Eslami1, Priscilla Anyimiah1,2,3, Sjoukje van der Werf4

  • 1Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands.

Antibiotics (Basel, Switzerland)
|May 27, 2026
PubMed
Abstract

Insights

Older adults with respiratory syncytial virus (RSV) often receive unnecessary antibiotics due to diagnostic uncertainty, despite low rates of bacterial infection. This highlights the need for rapid diagnostics and antimicrobial stewardship to reduce antibiotic use.

Area of Science:

  • Geriatrics
  • Infectious Diseases
  • Public Health

Background:

  • Respiratory syncytial virus (RSV) is a significant cause of respiratory illness in older adults.
  • Overlapping symptoms with bacterial infections and delayed diagnosis lead to unnecessary antibiotic prescriptions, contributing to antimicrobial resistance (AMR).

Purpose of the Study:

  • To systematically review antibiotic prescription patterns in older adults diagnosed with RSV.
  • To identify factors influencing antibiotic prescribing decisions in this demographic.

Main Methods:

  • A systematic review of observational studies published between January 2000 and August 2025 was conducted.
  • Searches included PubMed/MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Scopus.
  • Studies included adults aged ≥60 or ≥65 years with RSV infection and reported antibiotic use.

Main Results:

  • Antibiotic prescribing ranged from 40.0% to 97.7%, while confirmed bacterial infections were below 20% in all included studies.
  • Antibiotic use was linked to diagnostic uncertainty, imaging results, inflammatory markers, respiratory distress, delayed RSV testing, and comorbidities, not bacterial confirmation.
  • Hospitalization rates varied, with length of stay (LOS) between 3.5 and 11 days; no studies reported antibiotic discontinuation after RSV confirmation.

Conclusions:

  • Older adults with RSV are frequently prescribed antibiotics empirically, despite low rates of concurrent bacterial infection.
  • Implementing rapid diagnostics, reassessing antibiotic therapy, and enhancing antimicrobial stewardship are crucial for reducing unnecessary antibiotic use.
  • RSV vaccination may indirectly reduce antibiotic use by preventing severe disease and hospitalizations, though this remains hypothetical.
Keywords:
antibiotic prescribingantimicrobial resistanceantimicrobial stewardshipbacterial co-infectionolder adultsrespiratory infectionsrespiratory syncytial virussystematic review

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