Background:
Influenza infections result in both inappropriate and appropriate antibiotic
prescribing. There is a huge burden of
both influenza and infections with antimicrobial
resistant (AMR) pathogens
in Africa.
Influenza vaccines have the potential to reduce
both appropriate antibiotic use, through the reduction in secondary bacterial infections,
as well as to reduce levels of i
nfluenza misdiagnosed
and treated as a bacterial infection
(inappropriate).
Objectives:
To estimate potential reductions in antibiotic use achievable by introducing
an influenza vaccine to various African settings.
Methods:
I
nfluenza
incidence
was combine
d with
population size
,
vaccine
and
health
system characteristics.
Results
:
We estimated
that the direct impact of vaccination could avert
more than 390
prescriptions per
100,000 population
per year
if a 50% efficacious influenza vaccine at
30% coverage w
ere introduced to adults >65 y
ears old (yo)
in South Africa or children
2
-
5
yo in Senegal. Across Africa,
purely through reducing the number of severe acute
respiratory infections, the same vaccine characteristics could avert
at least
2
4
,000
antibiotic prescriptions
per year
if
given to
children <
5
years
.
Conclusions:
The introduction of an influenza vaccine into multiple African settings
could have a dramatic indirect impact on antibiotic usage.
Our values are limited
underestimates, captur
ing only the direct impact of vaccination in a few settings and
risk groups. This is due to the
huge lack of epidemiological information on
antibiotic
use
and influenza in Africa
.
However, it is likely that influenza vaccination in Africa
could substantially impact
antibiotic usage in addition to influenza
-
related
mortality
and
morbidity
.