Hak Sarah F, Venekamp Roderick P, Billard Marie-Noëlle, Cianci Daniela, Van Houten Marlies A, Pollard Andrew J, Heikkinen Terho, Cunningham Steve, Millar Margaret, Martinon-Torres Federico, Dacosta-Urbieta Ana, Bont Louis J, Wildenbeest Joanne G
Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
J Antimicrob Chemother. 2025 Jul 1;80(7):1803-1812. doi: 10.1093/jac/dkaf123.
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 (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.
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.
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.
生命早期使用抗生素会影响微生物群组成，并促使抗菌药物耐药性的出现。尽管呼吸道合胞病毒（RSV）是急性呼吸道感染（ARI）的主要病因，但目前仍缺乏对RSV所致抗生素使用情况的准确估计。
评估生命第一年中与RSV相关的抗生素使用情况。
RESCEU出生队列研究对2017年7月1日至2020年7月31日期间出生于五个欧洲国家的健康足月儿（n = 9154）进行随访，以确定婴儿期RSV-ARI住院情况。在一个嵌套队列（n = 993）中，我们在RSV流行季节（10月至次年4月），若出现ARI症状则通过采集鼻拭子进行主动RSV监测。住院期间的抗生素使用情况通过病历审查确定，门诊数据则通过家长问卷收集。
在整个队列中，22.8%的RSV住院患者（33/145）和62.5%的RSV重症监护入院患者（5/8）使用了抗生素。在嵌套队列中，任何严重程度的RSV-ARI患者中有5.2%（13/250）使用了抗生素，接受医疗护理的RSV-ARI患者中有9.9%（13/131）使用了抗生素。这导致估计在生命第一年中，1.3%（95%CI：0.8-2.0）的健康足月儿接受了≥1疗程与RSV感染相关的抗生素治疗，每1000婴儿月的RSV相关抗生素处方发生率为1.1（95%CI：0.6-1.9）。因此，RSV占RSV流行季节ARI抗生素处方的22.9%。
77名健康足月儿中有1名在1岁生日前RSV感染期间接受了抗生素治疗。需要真实世界的证据来确定RSV免疫对婴儿期抗生素使用的影响。
NCT03627572。
