Evaluating the impact of RSV immunisation strategies on antibiotic use in England

Abstract

AbstractWith a sizable fraction of primary care antibiotics prescribing attributable to RSV, the promising suite of prophylactic pharmaceuticals against could reduce the need for antibiotics in addition to controlling respiratory disease. To assess the potential impact of RSV vaccines on the reduction in primary care antibiotic prescribing in England, we integrate results from a dynamic transmission model of RSV and a statistical attribution framework. Under base case assumptions, targeting children aged 5-14 years reduces antibiotic prescribing by 10.9 (8.0-14.2) antibiotic courses per 10,000 person years. This reduction in antibiotic use would gain 128 DALYs and avert 51,000 GBP associated with infections caused by drug resistant bacteria. Seasonally administering monoclonal antibodies (mAbs) to high risk infants under 6 months is the most efficient strategy (reducing per person year antibiotic prescribing by 2.6 (1.9-3.3) antibiotic courses per 1,000 mAb courses).