Antiviral Prescribing for Flu Examined Among High-Risk Patients

The investigators determined that empiric treatment of 4 patients with acute respiratory illness who were considered high-risk was needed to treat 1 with positive influenza laboratory tests.

High-risk outpatients with acute respiratory illness (ARI) may be infrequently prescribed influenza antiviral medications even though they may benefit most from treatment, according to findings published in the journal Clinical Infectious Diseases.

To better understand the prescribing habits of antivirals for influenza treatment, researchers specifically looked at what factors impacted how these medications were utilized. Currently, clinicians can choose among amantadine, oseltamivir, rimantadine, or zanamivir to treat the infection. Oseltamivir and zanamivir are indicated for use in patients who have been symptomatic for no more than two days.

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The investigative team evaluated data from the US Influenza Vaccine Effectiveness Network collected during the 2011 to 2016 seasons (n=4861). Clinical information from patient interviews and electronic medical records were pooled as well as results from patients who were tested using rRT-PCR. 

The results showed that 15% (718/4861) of patients who had symptoms within ≤48 hours and presented for care (early) received treatment, including 37% (472/1292) of patients with rRT–PCR-confirmed influenza. However, only 40% of high-risk patients presented early for treatment. Seeking earlier medical attention (OR: 4.1, CI: 3.5–4.8) and fever (OR: 3.2, CI: 2.7–3.8) were both associated with antiviral treatment.

The investigators determined that “empiric treatment of 4 high-risk outpatients with ARI was needed to treat 1 patient with laboratory-confirmed influenza”.  They concluded by stating that “efforts to increase appropriate antiviral prescribing are needed to reduce influenza-associated complications.”

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