Exploring the impact of rotavirus vaccination on antibiotic prescription and resistance: A comprehensive systematic review

Table 1 Characteristics of the publications included in the current systematic review

Ref.	Country	Study type	Study period	Population	Intervention	Other vaccinations (PCV, etc.)	Comparison	Assessment for (history of infections)	History of antibiotic use	Any antibiotic prescription	Antibiotic prescription following AGE	Antimicrobial resistance
Hall et al[7], 2022	Unite States	Retrospective cohort study	2007-2018	Children aged 5 born 2007-2018	RV	PCV	Children with no RV	AGE	Aminoglycosides, cephalosporin, β-lactam, erythromycin and macrolide, penicillins, miscellaneous antibiotics, quinolones, sulfonamides and combination, sulfones	NS	55.4% received antibiotics during the follow-up period; 1.5% of antibiotic prescriptions followed an AGE diagnosis	NS
Lewnard et al[16], 2020	Gambia; Mali; Mozambique; Kenya; Bangladesh; India; Pakistan	Case-control study	2007-2011	Children aged 0–59 months with diarrhea	None	NS	Children without diarrhea	AGE caused by Salmonella, Shigella, Campylobacter, Aeromonas, and Vibrio spp Escherichia coli	NS	NS	NS	NS
Lewnard et al[17], 2020	Kenya, Bangladesh, India	Case–control study	2015-2019	Children aged < 5 years with acute respiratory infections and diarrhea in the 2 wk prior to the study	RV	PCV10/13	Children aged < 5 years unvaccinated for RV/PCV	Acute respiratory infection and diarrhea	NS	NS	NS	NS
At Thobari et al[15], 2020	Indonesia	Phase IIb randomized, double-blinded, controlled trial	January 2013 through July 2016	0-18 months of age	RV3-BB RV	NS	Placebo	NS	551 infants received ≥ 1 antibiotic in the 18-month observation period	956 antibiotic courses, 1.74 antibiotic uses per infant, mean duration of antibiotic use per child was 4.92 (± 1.86) d; no significant association between sex or vaccination group and the duration of antibiotic courses	NS	NS
Perez-Scha et al[14], 1990	Venezuela	Clinical/field trial	≥ 1 year and 1 year follow-up; sequential vaccine administration in 4 periods: February-March 1985, June-July 1985, October 1985, and February 1986	< 6 months of age	RV	NS	Placebo	The provided text does not mention a specific section on the history of infections (gastroenteritis) in the study	NS	NS	NS	NS

PCV: Pneumococcal conjugate vaccine; RV: Rotavirus vaccination/vaccine; NS: Not specified; AGE: Acute gastroenteritis.

Table 2 Risk of bias analysis for the included studies

Ref.	Selection				Comparability	Outcome			Total1
	Representativeness of exposed cohort	Selection of non-exposed cohort	Ascertainment of exposure	Demonstration that outcome of interest was not present at start of the study	Comparability of cohorts based on basis of design or analysis	Assessments of outcomes	Was follow-up long enough for outcomes to occur	Adequacy of follow-up of cohorts
Hall et al[7], 2022	1	0	1	1	1	1	0	0	5
Lewnard et al[16], 2020	1	0	1	1	2	1	1	1	8
Lewnard et al[17], 2020	1	0	1	1	1	1	1	1	7
At Thobari et al[15], 2020	1	1	1	1	2	1	1	1	9
Perez-Schae et al[14], 1990	1	1	1	1	2	1	1	1	9

¹Quality score of < 3: Low quality of evidence; 3-6: Moderate quality of evidence; ≥ 7: High quality of evidence.