Early oseltamivir use leads to better outcomes for patients hospitalized with flu
Click Here to Manage Email Alerts
Key takeaways:
- Initiating oseltamivir on the day of admission resulted in better outcomes for patients hospitalized with influenza.
- It was associated with lower odds of ICU admission, death and lower disease severity.
Patients hospitalized with influenza and treated with oseltamivir on the day of admission were less likely to experience severe clinical outcomes compared with those who were treated later, researchers found.
“Randomized clinical trials that can evaluate the benefit of antiviral treatment for hospitalized influenza patients (vs. no treatment) are rare and difficult to execute. In addition, we know that the timing of treatment is an important factor in achieving the greatest benefit from these medications,” Nathaniel M. Lewis, PhD, Epidemic Intelligence Service (EIS) officer with CDC’s Influenza Division, told Healio.
“Observational studies conducted in hospital settings like this one can therefore provide another avenue for evaluating the benefit of antivirals for hospitalized patients, and against various severe influenza-associated outcomes. The IVY Network, a CDC platform that collects detailed clinical data on its patients, provided an excellent opportunity to conduct such an analysis,” Lewis said.
To assess the clinical benefit of the current guidelines, which say to treat adults hospitalized with acute influenza with oseltamivir as early as possible after admission, Lewis and colleagues prospectively enrolled adults aged 18 years and older who were hospitalized with laboratory-confirmed influenza at 24 hospitals during between Oct. 1, 2022, and July 21, 2023.
According to the study, they used a multivariable proportional odds model to compare peak pulmonary disease severity — assessed by oxygen support, standard supplemental oxygen, high-flow oxygen/noninvasive ventilation, invasive mechanical ventilation or death — after the day of hospital admission. Patients who either started oseltamivir treatment the day of admission (early) were then compared with those who did not (late or not treated), and evaluated for odds of ICU admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.
In total, 840 patients with influenza were analyzed — 415 of whom started oseltamivir on the day of admission and 425 who did not.
According to the study, patients treated early with oseltamivir had lower peak pulmonary disease severity (adjusted OR = 0.6; 95% CI, 0.49-0.72) compared with those treated later or not treated at all.
These patients also had lower odds of ICU admission (aOR = 0.24; 95% CI, 0.13-0.47), acute kidney replacement therapy or vasopressor use (aOR = 0.4; 95% CI, 0.22-0.67) and in-hospital death (aOR = 0.36; 95% CI, 0.18-0.72).
“Our findings reinforce the current Infectious Diseases Society of America and CDC guidelines for hospitalized influenza patients, which are to initiate antiviral treatment with oseltamivir as soon as possible after admission,” Lewis concluded.
Collapse
Read more about
Click Here to Manage Email Alerts