Early neuraminidase inhibition shortens hospital length of stay in influenza-infected patients
Early treatment with the neuraminidase inhibitor (NAI) oseltamivir results in shorter length of stay (LOS) in patients hospitalized for influenza, a study has shown.
The retrospective study included 699 patients admitted with influenza, among whom 83.4 percent (n=582) received NAI therapy and only 26.0 percent received the first dose within 6 hours of hospitalization (early group).
Linear and logistic regression analyses showed that NAI was likely to be administered early for patients with diabetes mellitus (p=0.01), pregnancy (p<0.001), fever (p=0.002) or myalgias (p=0.005) at presentation. Immunosuppressed patients were less likely to receive early NAI (p=0.04).
Early NAI was associated with shorter hospital LOS (p<0.001). None of the patients who received early NAI therapy died, whereas 18 deaths occurred among the 399 patients receiving NAI after 6 hours (4.5 percent) and four deaths among the 116 patients not receiving NAI (3.4 percent).
The present data highlight the importance of facilitating earlier therapy in patients with suspected influenza, researchers said, adding that there appears to be a delay in initiating early empiric therapy with NAIs, which has not garnered the same policy attention as early antibacterials for sepsis.
Researchers pointed out a lack of clear guidance to advocate for pre-emptive anti-influenza antivirals for patients with community-acquired pneumonia, despite increasing evidence suggesting viruses, including influenza, are a major cause of pneumonia.