Pia Hardelid1,2, Yonas Ghebremichael-Weldeselassie3, Heather Whitaker3, Greta Rait4, Ruth Gilbert1, Irene Petersen2,5. 1. Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. 2. Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. 3. Statistics Group, Department of Mathematics and Statistics, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK. 4. PRIMENT Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. 5. Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, DK 8200 Aarhus N, Denmark.
Abstract
Objectives: To determine the effectiveness of live attenuated influenza vaccine (LAIV) in reducing amoxicillin prescribing in preschool children in primary care. Patients and methods: We used The Health Improvement Network (THIN), a large primary care database from the United Kingdom. We included children aged 2 to 4 years old at the start of either the 2013/14 or the 2014/15 winter season, with at least one amoxicillin prescription between September and May, irrespective of LAIV vaccination status. We used the self-controlled case series method to estimate influenza vaccine effectiveness (VE). Results: The total study sample included 33 137 children from 378 general practices during the two winter seasons. Of these children, 43.4% with at least one amoxicillin prescription had been vaccinated. The rate of amoxicillin prescribing was significantly reduced during periods of influenza vaccine immunity. The associated VE for amoxicillin prescribing was 12.8% (95% CI 6.9%, 18.3%) in 2013/14 and 14.5% (9.6%, 19.2%) in 2014/15. Given a VE of 14.5%, we estimated that amoxicillin prescribing could have been reduced by 5.6% if LAIV uptake in children aged 2-4 years increased to 50% in the 2014/15 winter season. Conclusions: Influenza vaccination of young children may contribute to a reduction in the prescribing of amoxicillin, one of the most commonly prescribed antibiotics in primary care. Further studies are required to confirm the size of the effect.
Objectives: To determine the effectiveness of live attenuated influenza vaccine (LAIV) in reducing amoxicillin prescribing in preschool children in primary care. Patients and methods: We used The Health Improvement Network (THIN), a large primary care database from the United Kingdom. We included children aged 2 to 4 years old at the start of either the 2013/14 or the 2014/15 winter season, with at least one amoxicillin prescription between September and May, irrespective of LAIV vaccination status. We used the self-controlled case series method to estimate influenza vaccine effectiveness (VE). Results: The total study sample included 33 137 children from 378 general practices during the two winter seasons. Of these children, 43.4% with at least one amoxicillin prescription had been vaccinated. The rate of amoxicillin prescribing was significantly reduced during periods of influenza vaccine immunity. The associated VE for amoxicillin prescribing was 12.8% (95% CI 6.9%, 18.3%) in 2013/14 and 14.5% (9.6%, 19.2%) in 2014/15. Given a VE of 14.5%, we estimated that amoxicillin prescribing could have been reduced by 5.6% if LAIV uptake in children aged 2-4 years increased to 50% in the 2014/15 winter season. Conclusions: Influenza vaccination of young children may contribute to a reduction in the prescribing of amoxicillin, one of the most commonly prescribed antibiotics in primary care. Further studies are required to confirm the size of the effect.
Authors: Sara Boccalini; Elena Pariani; Giovanna Elisa Calabrò; Chiara DE Waure; Donatella Panatto; Daniela Amicizia; Piero Luigi Lai; Caterina Rizzo; Emanuele Amodio; Francesco Vitale; Alessandra Casuccio; Maria Luisa DI Pietro; Cristina Galli; Laura Bubba; Laura Pellegrinelli; Leonardo Villani; Floriana D'Ambrosio; Marta Caminiti; Elisa Lorenzini; Paola Fioretti; Rosanna Tindara Micale; Davide Frumento; Elisa Cantova; Flavio Parente; Giacomo Trento; Sara Sottile; Andrea Pugliese; Massimiliano Alberto Biamonte; Duccio Giorgetti; Marco Menicacci; Antonio D'Anna; Claudia Ammoscato; Emanuele LA Gatta; Angela Bechini; Paolo Bonanni Journal: J Prev Med Hyg Date: 2021-09-10
Authors: Kathrin U Jansen; William C Gruber; Raphael Simon; James Wassil; Annaliesa S Anderson Journal: Environ Chem Lett Date: 2021-09-29 Impact factor: 13.615