Flu antiviral saves lives in some severe infections
Study also finds vaccine failure in elderly
McGeer A, Green K, Plevneshi A, et al. Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada. Clin Infect Dis 2007; 45:1,568-1,575.
In this prospectively identified cohort of patients with laboratory-confirmed influenza requiring hospital admission, treatment of adults with oseltamivir was associated with a clinically significant reduction in mortality within 15 days, the authors found.
"This analysis contributes to the accumulating evidence that, in addition to reducing influenza complications in otherwise healthy adults, neuraminidase inhibitors have a role in the treatment of more seriously ill patients," the authors noted. However, the study also underscores that flu vaccination does not guarantee immunity, particularly in elderly and immune compromised populations. Of the 303 patients for whom data were available, 216 (71%) had been vaccinated. Vaccinated individuals included six (18%) of 33 previously healthy patients aged 18-64 years, 24 (56%) of 43 patients aged 8 to 64 years with chronic underlying illness, and 186 (82%) of 227 patients more than 65 years old.
"There was a significant burden of illness attributable to influenza in this highly vaccinated population," they noted. ". . . These data demonstrate that life-threatening influenza may still occur in highly vaccinated populations in years when the vaccine is well matched to the infecting strains."
Patients admitted to Toronto Invasive Bacterial Diseases Network hospitals with laboratory-confirmed influenza from January 2005 through May 2006 were enrolled in the study. Of the 327 adult patients, 184 (59%) presented to the emergency department within 48 hours of symptom onset, 52 (16%) required intensive care unit admission, and 27 (8.3%) died within 15 days after symptom onset. Overall, 292 (89%) received antibacterial therapy and 106 (32%) were prescribed antiviral drugs. Treatment with antiviral drugs active against influenza was associated with a significant reduction in mortality, but there was no apparent impact of antiviral therapy on length of stay in survivors, the authors noted.
In this prospectively identified cohort of patients with laboratory-confirmed influenza requiring hospital admission, treatment of adults with oseltamivir was associated with a clinically significant reduction in mortality within 15 days, the authors found.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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