Respiratory Virus Detections, Antibiotic Prescribing Rates Decreased ‪‬During COVID-19 Pandemic

The researchers tested their hypothesis that a decrease in respiratory virus incidence would be associated with a reduction in inappropriate ambulatory antibiotic orders.

Public health measures instituted during the COVID-19 pandemic led to a significant ‪decrease in respiratory virus detections as well as a decline in ‪antibiotic prescribing rates for respiratory tract infections (RTIs), according to a research letter published in JAMA Internal Medicine.

To test the hypothesis that a decrease in respiratory virus detections may be associated with a ‪decline in inappropriate antibiotic prescribing for RTIs during the COVID-19 pandemic, researchers compared ambulatory antibiotic prescribing data from the University of Wisconsin Health system from a pre-COVID-19 pandemic period (July 2018 to February 2020) with a COVID-19 pandemic period (April 2020 to February 2021).

Compared with seasons prior to the COVID-19 pandemic, detection of winter seasonal viruses during the COVID-19 pandemic was much lower (4800 vs 12 per month; P <.001), including detection of other respiratory viruses (560 vs 228 per month; P <.001).

Although antibiotic prescribing rates increased during winter respiratory viral seasons before the COVID-19 pandemic, antibiotic prescribing rates decreased during the pandemic period. Inappropriate antibiotic prescribing declined by 79% from 10.5 to 2.2 prescriptions per 1000 patient encounters (P <.001).

The strongest correlation with antibiotic prescribing for RTI during the COVID-19 pandemic was with noninfluenza virus detections (r=0.82; P <.001).

“The data suggest that COVID-19 transmission mitigation strategies may help curb respiratory viral diseases beyond SARS-CoV-2 and, indirectly, decrease antibiotic prescribing,” concluded the researchers.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Lepak AJ, Taylor LN, Stone CA, et al. Association of changes in seasonal respiratory virus activity and ambulatory antibiotic prescriptions with the COVID-19 pandemic. JAMA Intern Med. Published online June 21, 2021. doi:10.1001/jamainternmed.2021.2621

This article originally appeared on Infectious Disease Advisor