antiobiotics, pill, in hands

Increasing influenza vaccination coverage reduces prescribing for certain classes of antibiotics, a new study finds.

Researchers from Kaiser Permanente and Harvard University estimated flu-associated prescribing for five antibiotic classes: macrolides, aminopenicillins, protected aminopenicillins, quinolones and third-generation cephalosporins.

The results showed a “modest benefit” of increased flu vaccination for reducing antibiotic prescribing. In older adults, the effect was seen in macrolides for people aged 50 years and older and in third generation cephalosporins among adults aged 65 and older, the researchers reported.

In addition, in adults aged 25 years and older, investigators found that 45% to 84% of influenza-associated antibiotic prescribing was for respiratory diagnoses not caused by bacteria. 

The findings suggest that vaccination and other measures to reduce unnecessary antibiotic prescribing “may further contribute to the mitigation of antimicrobial resistance,” they wrote.

Tough flu season in store?

The findings come as federal health officials raise concerns about the potential for an especially harsh flu season. As of Oct. 28, the Centers for Disease Control and Prevention continued to report early increases in seasonal influenza activity in the United States, especially in the southeast and south-central areas. The cumulative U.S. hospitalization rate was higher that week than it has been in 12 years. 

Monitoring of countries in the Southern hemisphere, often a harbinger of what is to come, have shown an earlier-than-usual uptick in cases with hospitalizations up year-over-year. The number of U.S. nursing homes reporting at least one flu-positive test among residents is also rising, although it remains low, at 0.5%.

With an expectation that COVID-19 cases will rise as well this season, officials are campaigning for older adults to get vaccinated for flu along with receiving an updated, bivalent COVID-19 booster shot. This year, the CDC has for the first time preferentially advised older patients to take an adjuvanted or high-dose flu vaccine over standard vaccines whenever possible. These include:

  • Quadrivalent high-dose inactivated influenza vaccine (HD-IIV4);
  • Quadrivalent recombinant influenza vaccine (RIV4); or 
  • Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4). 

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