Politis Marios, Chatzichristodoulou Ioanna, Mouchtouri Varvara A, Rachiotis Georgios
Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
Center for Epidemiology and Community Medicine, Stockholm Health Care Services, Stockholm, Sweden.
Infect Prev Pract. 2025 Jun 3;7(3):100461. doi: 10.1016/j.infpip.2025.100461. eCollection 2025 Sep.
Vaccinations are considered one of the most effective medical interventions. Among other benefits, certain vaccinations help reduce antimicrobial resistance by decreasing antibiotic use. Considering reports of increased antimicrobial resistance during the COVID-19 pandemic, this study aimed to explore the relationship between COVID-19 vaccination status and antibiotic use in COVID-19 patients.
A systematic literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar between January 1, 2021, and November 6, 2024. The included studies were assessed for risk of bias using the Newcastle-Ottawa tool. Narrative synthesis and random-effects meta-analysis were employed to synthesize the evidence.
Eight studies were included in this systematic review and meta-analysis (134,022 participants). COVID-19 vaccination was significantly associated with a 34% reduction in the odds of antibiotic use (OR: 0.662; 95% CI: 0.540-0.811) in COVID-19 patients. These findings were supported by the sensitivity analyses. In the subgroup analysis, a significant negative association was observed between COVID-19 vaccination and antibiotic use among COVID-19 patients across all study designs. A major limitation of this study is that most of the included studies did not adjust for confounders.
COVID-19 vaccination was associated with a significant reduction in antibiotic use among COVID-19 patients. COVID-19 vaccination status may have influenced healthcare providers' decisions regarding antibiotic use in this group. Further large-scale cohort studies are needed to confirm these findings.
The study protocol is registered with PROSPERO (ID: CRD42023449625). No funding was provided for this study. The APCs were covered by the Karolinska Institute.
疫苗接种被认为是最有效的医学干预措施之一。除其他益处外，某些疫苗接种通过减少抗生素使用有助于降低抗菌药物耐药性。鉴于有报告称在新冠疫情期间抗菌药物耐药性有所增加，本研究旨在探讨新冠疫苗接种状况与新冠患者抗生素使用之间的关系。
于2021年1月1日至2024年11月6日在PubMed、Scopus、Web of Science、Embase和谷歌学术上进行了系统的文献检索。使用纽卡斯尔 - 渥太华工具对纳入的研究进行偏倚风险评估。采用叙述性综合分析和随机效应荟萃分析来综合证据。
本系统评价和荟萃分析纳入了8项研究（134,022名参与者）。新冠疫苗接种与新冠患者抗生素使用几率显著降低34%相关（比值比：0.662；95%置信区间：0.540 - 0.811）。敏感性分析支持了这些发现。在亚组分析中，在所有研究设计的新冠患者中，观察到新冠疫苗接种与抗生素使用之间存在显著的负相关。本研究的一个主要局限性是，大多数纳入研究未对混杂因素进行调整。
新冠疫苗接种与新冠患者抗生素使用显著减少相关。新冠疫苗接种状况可能影响了医疗保健提供者对该组患者抗生素使用的决策。需要进一步的大规模队列研究来证实这些发现。
该研究方案已在PROSPERO注册（ID：CRD42023449625）。本研究未获得资金支持。文章处理费由卡罗林斯卡学院承担。
