Abstract Background Improving appropriate antibiotic use is crucial for combating antibiotic resistance and unnecessary adverse drug reactions. Acute respiratory illness (ARI) commonly causes outpatient visits and accounts for ~41% of antibiotics used in the United States (U.S.). We examined the influence of influenza vaccination on reducing antibiotic prescriptions among outpatients with ARI. Methods We enrolled outpatients aged ≥6 months with ARI from 50-60 U.S. clinics during five winters (2013-2018) and tested for influenza with RT-PCR; results were unavailable for clinical decision-making and clinical influenza testing was infrequent. We collected antibiotic prescriptions and diagnosis codes for ARI syndromes. We calculated vaccine effectiveness (VE) by comparing vaccination odds among influenza-positive cases to test-negative controls. We estimated ARI visits and antibiotic prescriptions averted by influenza vaccination using estimates of VE, coverage, and prevalence of antibiotic prescriptions and influenza.



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Citation Emily R Smith, Alicia M Fry, Lauri A Hicks, Katherine E Fleming-Dutra, Brendan Flannery, Jill Ferdinands, Melissa A Rolfes, Emily T Martin, Arnold S Monto, Richard K Zimmerman, Mary Patricia Nowalk, Michael L Jackson, Huong Q McLean, Scott C Olson, Manjusha Gaglani, Manish M Patel, Reducing Antibiotic Use in Ambulatory Care through Influenza Vaccination, Clinical Infectious Diseases, , ciaa464, https://doi.org/10.1093/cid/ciaa464