| Title: |
Impact of influenza vaccination on amoxicillin prescriptions in older adults: A retrospective cohort study using primary care data |
| Authors: |
Rodgers, LR; Streeter, AJ; Lin, N; Hamilton, W; Henley, WE |
| Contributors: |
Ramagopalan SV |
| Publisher Information: |
Public Library of Science; United States |
| Publication Year: |
2021 |
| Collection: |
PEARL (Plymouth Electronic Archiv & ResearchLibrary, Plymouth University) |
| Subject Terms: |
Aged; 80 and over; Amoxicillin; Bacterial Infections; Drug Prescriptions; Female; Humans; Influenza Vaccines; Influenza; Human; Male; Primary Health Care; Retrospective Studies; United Kingdom; Vaccination |
| Description: |
Background Bacterial infections of the upper and lower respiratory tract are a frequent complication of influenza and contribute to the widespread use of antibiotics. Influenza vaccination may help reduce both appropriate and inappropriate prescribing of antibiotics. Electronic health records provide a rich source of information for assessing secondary effects of influenza vaccination. Methods We conducted a retrospective study to estimate effects of influenza vaccine on antibiotic (amoxicillin) prescription in the elderly based on data from the Clinical Practice Research Datalink. The introduction of UK policy to recommend the influenza vaccine to older adults in 2000 led to a substantial increase in uptake, creating a natural experiment. Of 259,753 eligible patients that were unvaccinated in 1999 and aged≥65y by January 2000, 88,519 patients received influenza vaccination in 2000. These were propensity score matched 1:1 to unvaccinated patients. Time-to-amoxicillin was analysed using the Prior Event Rate Ratio (PERR) Pairwise method to address bias from time-invariant measured and unmeasured confounders. A simulation study and negative control outcome were used to help strengthen the validity of results. Results Compared to unvaccinated patients, those from the vaccinated group were more likely to be prescribed amoxicillin in the year prior to vaccination: hazard ratio (HR) 1.90 (95% confidence interval 1.83, 1.98). Following vaccination, the vaccinated group were again more likely to be prescribed amoxicillin, HR 1.64 (1.58,1.71). After adjusting for prior differences between the two groups using PERR Pairwise, overall vaccine effectiveness was 0.86 (0.81, 0.92). Additional analyses suggested that provided ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
e0246156-e0246156; Electronic-eCollection; application/pdf |
| Language: |
English |
| ISSN: |
1932-6203 |
| Relation: |
E-ISSN:1932-6203; e0246156; http://hdl.handle.net/10026.1/18144 |
| DOI: |
10.1371/journal.pone.0246156 |
| Availability: |
http://hdl.handle.net/10026.1/18144; https://doi.org/10.1371/journal.pone.0246156 |
| Accession Number: |
edsbas.CE5EBBA |
| Database: |
BASE |