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Published on: January 2, 2017

The Effectiveness of Nirsevimab on Antibiotic Use in Children Using Target Trial Emulation

Mahaa M Ahmed1, Torsten Joerger2, Ziyi Wang1

  • 1Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 6, 2026
PubMed

Insights

Nirsevimab significantly reduced antibiotic prescribing for infants with acute respiratory tract infections (ARTIs). This monoclonal antibody therapy lowered antibiotic use in both outpatient and inpatient settings for ARTIs and RSV-related hospitalizations.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Nirsevimab is a monoclonal antibody effective against respiratory syncytial virus (RSV) infections in infants.
  • Acute respiratory tract infections (ARTIs) in infants often lead to antibiotic prescriptions.
  • The study evaluated nirsevimab's impact on antibiotic prescribing for medically attended ARTIs in infants.

Purpose of the Study:

  • To determine the effectiveness of nirsevimab in reducing antibiotic prescribing among infants with acute respiratory tract infections (ARTIs).
  • To assess nirsevimab's impact on antibiotic use in outpatient settings for ARTIs and bronchiolitis.
  • To evaluate nirsevimab's effect on antibiotic prescriptions for RSV-related hospitalizations.

Main Methods:

  • A target trial emulation using electronic health records from 32 primary care practices.
  • Inclusion criteria: infants under 8 months old seen within 14 days of life.
  • Primary outcomes: time to first antibiotic prescription for outpatient ARTIs, bronchiolitis, and RSV-related hospitalizations.

Main Results:

  • Nirsevimab was administered to 7413 out of 15,341 eligible infants.
  • A 14.4% reduction in antibiotic prescribing for outpatient ARTIs was observed.
  • Significant reductions were noted for antibiotic prescribing in bronchiolitis (40.3%) and RSV-related hospitalizations (69.4%).

Conclusions:

  • Nirsevimab administration in primary care settings effectively reduced antibiotic use for ARTIs.
  • The benefits extended to both ambulatory and inpatient care scenarios.
  • Nirsevimab represents a strategy to curb antibiotic overuse in infant respiratory infections.
Abstract

Keywords:
RSVantibioticscausal inferencenirsevimabvaccine

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