Prescription of Antibiotics Among Patients Receiving Oseltamivir with an Influenza Related Diagnosis Over Three Influenza Seasons

Antimicrobial resistance is one of the global public health threats. It's been shown that influenza infections can lead to unnecessary antimicrobial use or bacterial pneumonia that requires antimicrobial therapy contributing to antimicrobial resistance. We aimed to demonstrate the utilization of antibiotics among patients receiving oseltamivir with an influenza related diagnosis. Data of patients admitted over three influenza seasons between 3 October 2016 and 20 May 2019 to 6 hospitals across Türkiye were included. Cases with ICD.10 codes J09 to J18 were screened and those who were prescribed oseltamivir were included in the analyses of antibiotic prescriptions. The analysis was performed using the Python programming language. The oseltamivir cohort comprised 12,222 cases, 4924 (40%) of whom were inpatients and 52% were female. The median age was 9 years (IQR, 49 years). The median length of hospital stay was 6 days (IQR, 9.4 days) and 89% of the cases revisited the hospital within ten days. While 5,483 of the patients were prescribed only oseltamivir, 6,739 have been prescribed oseltamivir + antibiotics at least once (Table). There was a clear seasonal trend in influenza diagnosis and antibiotic prescriptions, with peaks occurring annually, while the overall trend remains stable across the time span over three seasons. There was at least an 86% positive relationship between influenza cases and antibacterial prescriptions (Figure). The study findings indicate that influenza can contribute to unnecessary or preventable use of antibiotics and vaccination against influenza is a valuable tool to avoid antimicrobial resistance.