2733. Association Between Influenza Vaccination Coverage and Ambulatory Antibiotic Prescription Rates in Children in South Carolina

BACKGROUND: Prior studies demonstrated an increase in ambulatory antibiotic prescription rates during the peak of Influenza virus activity, which often occurs during the first 4 months of the year in Southeastern United States. However, the impact of Influenza vaccination coverage on antibiotic prescription rates remains undefined. The purpose of this retrospective cohort study is to examine the association between Influenza vaccination coverage and ambulatory antibiotic prescription rates in children in South Carolina from 2012 to 2017. METHODS: Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics were utilized for estimation of community antibiotic prescription rates in South Carolina population 6 months to 17 years of age from January 1, 2012 to December 31, 2017, which represents approximately 60% of the South Carolina population in this age group. Linear regression was used to examine the association between antibiotic prescription rates in January to April of each year and Influenza vaccine coverage in children 6 months to 17 years old after adjustments for Influenza vaccine effectiveness in that season as obtained from Centers for Disease Control and Prevention (CDC). RESULTS: During the 6-year study period, the mean antimicrobial prescription rate in children in South Carolina declined from 103 to 79 per 1000 person-months for the months January through April indicating a 26% decline (P < 0.0001). Influenza vaccine coverage also increased from 50.6% during the first Influenza season of the study and peaked at 60.7% in 2014–2015 Influenza season (Figure 1). After adjusting for the vaccine effectiveness, the decline in antibiotic prescription rate was significantly associated with an increase in vaccine coverage in children (P-value < 0.01). Antibiotic prescription rates declined by 3 per 1,000 person-months for each 1% increase in Influenza vaccine coverage in children. CONCLUSION: There is a temporal association between the increase in Influenza vaccination coverage and the decline in ambulatory antibiotic prescription rates in children in South Carolina. Achieving the CDC’s set target Influenza vaccination coverage of 70% of the population may be associated with greater decline in ambulatory antibiotic prescription rates in children in the future. [Image: see text] DISCLOSURES: All authors: No reported disclosures.