关于流感疫苗在预防成人流感样疾病(ILI)的抗生素处方中的有效性的证据是有限的。
进行了一项基于初级保健的病例对照研究,以评估40岁以上成年人针对流感样疾病(ILI)的流感疫苗有效性(VE)和ILI抗生素处方。病例为每年6月1日至9月30日诊断为ILI的患者,2015-2018年;还定义了ILI处方抗生素的子集。对照组是未接受ILI诊断的患者。广义估计方程用于计算调整后的总体VE,按年龄(<65岁与≥65岁)和共病状态划分。
ILI病例的数量从2018年的558例变化到2017年的2901例,控制从2015年的86618例变化到2017年的136763例。在4年中,针对ILI的VE的汇总估计值为24%(95CI,11%至34%),针对ILI的抗生素处方为15%(95CI,-3%至29%)。流感疫苗可有效降低65岁以下患者的ILI与相关抗生素处方(VE=23%,95CI,3%至38%),如果没有合并症记录(VE=22%,95CI,1%到39%),但在其他亚组中没有。
流感疫苗降低了低风险成年人(40-64岁和没有合并症的人)使用抗生素处方治疗ILI的可能性。
Evidence on the effectiveness of influenza vaccine in preventing antibiotic prescriptions for influenza-like illness (ILI) in adults is limited.
A primary care-based
case-control study was conducted to estimate influenza vaccine effectiveness (VE) against influenza-like illness (ILI) and antibiotic prescribing for ILI in adults aged ≥40 years. Cases were patients diagnosed with ILI from 1st June to 30th September in each year, 2015-2018; a subset of those with ILI prescribed antibiotics was also defined. Controls were patients attending a practice who did not receive an ILI diagnosis. Generalised estimating equations were used to calculate adjusted VE overall, by age (<65 versus ≥65 years) and comorbidity status.
The number of ILI cases varied from 558 in 2018 to 2901 in 2017 and controls from 86618 in 2015 to 136763 in 2017. Over 4 years the pooled estimate of VE was 24% (95%CI, 11% to 34%) against ILI and 15% (95%CI, -3% to 29%) against antibiotic prescription for ILI. Influenza vaccine was effective in reducing ILI with an associated antibiotic prescriptions in patients aged <65 years (VE=23%, 95%CI, 3% to 38%) and if no comorbidities were recorded (VE=22%, 95%CI, 1% to 39%) but not in other subgroups.
Influenza vaccine reduced the likelihood of antibiotic prescriptions for ILI in low-risk adults (40-64 years and those without comorbidities).