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Rapid diagnosis, treatment necessary to reduce influenza fatalities
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Rapid diagnosis and treatment of influenza are critical to reducing disease-related fatalities and hospitalizations, according to two studies published online this week.
In the first study, which was funded by the Canadian Institutes of Health, Caroline Chartrand, MD, of CHU Sainte-Justine in Montreal, and colleagues reviewed 159 published studies to test the accuracy of the newer rapid influenza diagnostic tests (RIDTs) in adults and children with influenza-like symptoms.
The researchers of the meta-analysis said a clinician can confidently make the diagnosis of influenza and begin appropriate infection-control measures and antiviral therapy, if indicated, after a positive result of an RIDT in a patient with influenza-like illness. This would avoid unnecessary additional diagnostic testing and antibiotics.
“A negative RIDT result has a reasonable likelihood of being false-negative and should be confirmed by other laboratory diagnostic tests if the result is likely to affect patient management,” the researchers wrote.
RIDTs were about 13% more sensitive in detecting influenza in pediatric patients compared with adults and were more accurate in detecting influenza virus A, which is more common than influenza virus B.
In the second study, Jonathan Hsu, BHSc, of McMaster University in Hamilton, Ontario, and colleagues reviewed data on the effectiveness of antiviral therapy in the treatment of influenza.
Researchers analyzed 74 published observational studies to assess the benefits and risks of oseltamivir (Tamiflu, Roche), zanamivir (Relenza, GlaxoSmithKline), amantadine and rimantadine.
The findings indicated that the use of oral oseltamivir for treatment of influenza may provide net benefit by reducing mortality, duration of symptoms and complications of influenza. In addition, the researchers said inhaled zanamivir seems to offer benefit over no treatment for patients with a positive influenza diagnosis. Influenza symptoms were reduced by about 1 day on oseltamivir compared with no treatment. Inhaled zanamivir seemed to reduce signs and symptoms of influenza and could shorten its duration.
The researchers said earlier treatment appears to have a greater benefit than later treatment. Although the study has its strengths, “potential bias reduces the confidence in the estimates of effect,” the researchers said. “Many of the identified studies were at high risk of observational study bias due to the lack of control for confounders and covariates.”
References:
- Chartrand C. Ann Intern Med. 2012
- Hsu J. Ann Intern Med. 2012; [Both published online ahead of print Feb. 27].
Disclosure:
- The researchers report no relevant financial disclosures.