tetano
Editor, Senior Moderator
Clin Infect Dis. 2017 Oct 23. doi: 10.1093/cid/cix922. [Epub ahead of print]
[h=1]Influenza Antiviral Prescribing for Outpatients with an Acute Respiratory Illness and at High Risk for Influenza-Associated Complications during Five Influenza Seasons-United States, 2011-2016.[/h] Stewart RJ[SUP]1,[/SUP][SUP]2[/SUP], Flannery B[SUP]2[/SUP], Chung JR[SUP]2[/SUP], Gaglani M[SUP]3[/SUP], Reis M[SUP]3[/SUP], Zimmerman RK[SUP]4[/SUP], Nowalk MP[SUP]4[/SUP], Jackson L[SUP]5[/SUP], Jackson M[SUP]5[/SUP], Monto AS[SUP]6[/SUP], Martin ET[SUP]6[/SUP], Belongia EA[SUP]7[/SUP], McLean H[SUP]7[/SUP], Fry AM[SUP]2[/SUP], Havers F[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Influenza causes millions of illnesses annually; certain groups are at higher risk for influenza-associated complications. Early antiviral treatment can reduce the risk of complications and is recommended for outpatients at increased risk. We describe antiviral prescribing among high-risk outpatients for 5 influenza seasons and explore factors that may influence prescribing.
[h=4]Methods:[/h] We analyzed antiviral prescription and clinical data for high-risk outpatients aged ≥ 6 months with an acute respiratory illness (ARI) and enrolled in the US Influenza Vaccine Effectiveness Network during the 2011-2012 to 2015-2016 influenza seasons. We obtained clinical information from interviews and electronic medical records and tested all enrollees for influenza with rRT-PCR. We calculated the number of patients with ARI that must be treated to treat 1 patient with laboratory-confirmed influenza.
[h=4]Results:[/h] Among high-risk outpatients with ARI who presented to care within two days of symptom onset (early), 15% (718/4861) were prescribed an antiviral medication, including 472/1292 (37%) of those with rRT-PCR-confirmed influenza. Less than half (40%) of high-risk outpatients with influenza presented to care early. Earlier presentation to care was associated with antiviral treatment (OR: 4.1, CI: 3.5-4.8), as was fever (OR: 3.2, CI: 2.7-3.8), although 25% of high-risk outpatients with influenza were afebrile. Empiric treatment of 4 high-risk outpatients with ARI was needed to treat 1 patient with laboratory-confirmed influenza.
[h=4]Conclusion:[/h] Influenza antiviral medications were infrequently prescribed for high-risk outpatients with ARI who would benefit most from treatment. Efforts to increase appropriate antiviral prescribing are needed to reduce influenza-associated complications.
[h=4]KEYWORDS:[/h] antiviral treatment; influenza; neuraminidase inhibitors; outpatient
PMID: 29069334 DOI: 10.1093/cid/cix922
[h=1]Influenza Antiviral Prescribing for Outpatients with an Acute Respiratory Illness and at High Risk for Influenza-Associated Complications during Five Influenza Seasons-United States, 2011-2016.[/h] Stewart RJ[SUP]1,[/SUP][SUP]2[/SUP], Flannery B[SUP]2[/SUP], Chung JR[SUP]2[/SUP], Gaglani M[SUP]3[/SUP], Reis M[SUP]3[/SUP], Zimmerman RK[SUP]4[/SUP], Nowalk MP[SUP]4[/SUP], Jackson L[SUP]5[/SUP], Jackson M[SUP]5[/SUP], Monto AS[SUP]6[/SUP], Martin ET[SUP]6[/SUP], Belongia EA[SUP]7[/SUP], McLean H[SUP]7[/SUP], Fry AM[SUP]2[/SUP], Havers F[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Influenza causes millions of illnesses annually; certain groups are at higher risk for influenza-associated complications. Early antiviral treatment can reduce the risk of complications and is recommended for outpatients at increased risk. We describe antiviral prescribing among high-risk outpatients for 5 influenza seasons and explore factors that may influence prescribing.
[h=4]Methods:[/h] We analyzed antiviral prescription and clinical data for high-risk outpatients aged ≥ 6 months with an acute respiratory illness (ARI) and enrolled in the US Influenza Vaccine Effectiveness Network during the 2011-2012 to 2015-2016 influenza seasons. We obtained clinical information from interviews and electronic medical records and tested all enrollees for influenza with rRT-PCR. We calculated the number of patients with ARI that must be treated to treat 1 patient with laboratory-confirmed influenza.
[h=4]Results:[/h] Among high-risk outpatients with ARI who presented to care within two days of symptom onset (early), 15% (718/4861) were prescribed an antiviral medication, including 472/1292 (37%) of those with rRT-PCR-confirmed influenza. Less than half (40%) of high-risk outpatients with influenza presented to care early. Earlier presentation to care was associated with antiviral treatment (OR: 4.1, CI: 3.5-4.8), as was fever (OR: 3.2, CI: 2.7-3.8), although 25% of high-risk outpatients with influenza were afebrile. Empiric treatment of 4 high-risk outpatients with ARI was needed to treat 1 patient with laboratory-confirmed influenza.
[h=4]Conclusion:[/h] Influenza antiviral medications were infrequently prescribed for high-risk outpatients with ARI who would benefit most from treatment. Efforts to increase appropriate antiviral prescribing are needed to reduce influenza-associated complications.
[h=4]KEYWORDS:[/h] antiviral treatment; influenza; neuraminidase inhibitors; outpatient
PMID: 29069334 DOI: 10.1093/cid/cix922