BACKGROUND: We assessed the association between early oseltamivir treatment and influenza complications in hospitalized patients. METHODS: A retrospective cohort study, including adults with laboratory-confirmed 2009 influenza A (H1N1) in three hospitals in Israel, was performed between July 2009 and January 2010, when admission was limited to high-risk patients. We compared patients treated with oseltamivir early versus late (>48 h after symptom onset). We analysed risk factors for complications, defined as radiographic pneumonia, hypoxia, mechanical ventilation, intensive care unit admission, haemodynamic support or in-hospital death. Risk factors for complications on univariate analysis were entered into a multivariable logistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (CI) are reported. RESULTS: Four hundred and forty-nine inpatients treated with oseltamivir were included, 189 (42.1%) of whom were treated early. Influenza complications occurred significantly more frequently among patients treated late with oseltamivir [150/260 (57.7%) versus 67/189 (35.4%), P < 0.001]. Late oseltamivir remained significantly associated with complications in the adjusted analysis (OR 2.37, 95% CI 1.52-3.70). Other independent risk factors included dyspnoea, disease severity on admission, lower sodium and treatment at one hospital; rhinorrhoea was protective. In an analysis adjusted for the propensity for early treatment the association remained significant (OR 2.21, 95% CI 1.41-3.46). Initiation of oseltamivir >48 h after admission was associated with a higher rate of complications documented after admission (OR 4.09, 95% CI 1.55-10.80). Severe complications (excluding hypoxia and uncomplicated pneumonia) occurred more frequently with late oseltamivir (adjusted OR 3.28,95% CI 1.56-6.89). CONCLUSIONS: Initiation of oseltamivir within 48 h of symptom onset was associated with fewer complications in patients hospitalized with 2009 influenza A (H1N1).
BACKGROUND: We assessed the association between early oseltamivir treatment and influenza complications in hospitalized patients. METHODS: A retrospective cohort study, including adults with laboratory-confirmed 2009 influenza A (H1N1) in three hospitals in Israel, was performed between July 2009 and January 2010, when admission was limited to high-risk patients. We compared patients treated with oseltamivir early versus late (>48 h after symptom onset). We analysed risk factors for complications, defined as radiographic pneumonia, hypoxia, mechanical ventilation, intensive care unit admission, haemodynamic support or in-hospital death. Risk factors for complications on univariate analysis were entered into a multivariable logistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (CI) are reported. RESULTS: Four hundred and forty-nine inpatients treated with oseltamivir were included, 189 (42.1%) of whom were treated early. Influenza complications occurred significantly more frequently among patients treated late with oseltamivir [150/260 (57.7%) versus 67/189 (35.4%), P < 0.001]. Late oseltamivir remained significantly associated with complications in the adjusted analysis (OR 2.37, 95% CI 1.52-3.70). Other independent risk factors included dyspnoea, disease severity on admission, lower sodium and treatment at one hospital; rhinorrhoea was protective. In an analysis adjusted for the propensity for early treatment the association remained significant (OR 2.21, 95% CI 1.41-3.46). Initiation of oseltamivir >48 h after admission was associated with a higher rate of complications documented after admission (OR 4.09, 95% CI 1.55-10.80). Severe complications (excluding hypoxia and uncomplicated pneumonia) occurred more frequently with late oseltamivir (adjusted OR 3.28,95% CI 1.56-6.89). CONCLUSIONS: Initiation of oseltamivir within 48 h of symptom onset was associated with fewer complications in patients hospitalized with 2009 influenza A (H1N1).
Authors: Carmen S Arriola; Evan J Anderson; Joan Baumbach; Nancy Bennett; Susan Bohm; Mary Hill; Mary Lou Lindegren; Krista Lung; James Meek; Elizabeth Mermel; Lisa Miller; Maya L Monroe; Craig Morin; Oluwakemi Oni; Arthur Reingold; William Schaffner; Ann Thomas; Shelley M Zansky; Lyn Finelli; Sandra S Chaves Journal: J Infect Dis Date: 2015-03-27 Impact factor: 5.226
Authors: Miguel Delgado-Rodríguez; Jesús Castilla; Pere Godoy; Vicente Martín; Nuria Soldevila; Jordi Alonso; Jenaro Astray; Maretva Baricot; Rafael Cantón; Ady Castro; Fernando Gónzález-Candelas; José María Mayoral; José María Quintana; Tomás Pumarola; Sonia Tamames; Marc Sáez; Angela Domínguez Journal: J Antimicrob Chemother Date: 2012-03-30 Impact factor: 5.790
Authors: Ignacio Martin-Loeches; Emili Díaz; Loreto Vidaur; Antoni Torres; Cesar Laborda; Rosa Granada; Juan Bonastre; Mar Martín; Josu Insausti; Angel Arenzana; Jose Eugenio Guerrero; Ines Navarrete; Jesus Bermejo-Martin; David Suarez; Alejandro Rodriguez Journal: Crit Care Date: 2011-11-28 Impact factor: 9.097
Authors: A Domínguez; A Romero-Tamarit; N Soldevila; P Godoy; M Jané; A Martínez; N Torner; J A Caylà; C Rius Journal: Epidemiol Infect Date: 2018-04-02 Impact factor: 4.434
Authors: Stuart R Dalziel; John Md Thompson; Charles G Macias; Ricardo M Fernandes; David W Johnson; Yehezkel Waisman; Nicholas Cheng; Jason Acworth; James M Chamberlain; Martin H Osmond; Amy Plint; Paolo Valerio; Karen Jl Black; Eleanor Fitzpatrick; Amanda S Newton; Nathan Kuppermann; Terry P Klassen Journal: BMJ Date: 2013-08-12