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Abstract

Background

Evidence of an oseltamivir treatment effect on influenza A(H3N2) virus infections in hospitalised patients is incomplete.

Aims

This cohort study aimed to evaluate risk factors for death among PCR-confirmed hospitalised cases of seasonal influenza A(H3N2) of all ages and the impact of oseltamivir.

Methods

Participants included all 332 PCR-confirmed influenza A(H3N2) cases diagnosed between 30 August 2016 and 17 March 2017 in an English university teaching Hospital. Oseltamivir treatment effect on odds of inpatient death was assessed by backward stepwise multivariable logistic regression analysis.

Results

The odds of death were reduced by two thirds (odds ratio (OR): 0.32; 95% confidence interval (CI): 0.11–0.93), in inpatients treated with a standard course of oseltamivir 75 mg two times daily for 5 days – compared with those untreated with oseltamivir, after adjustment for age, sex, current excess alcohol intake, receipt of 2016/17 seasonal influenza vaccine, serum haemoglobin and hospital vs community attribution of acquisition of influenza.

Conclusions

Oseltamivir treatment given according to National Institutes of Clinical Excellence (NICE); United States Centres for Disease Control and Prevention (CDC); Infectious Diseases Society of America (IDSA) and World Health Organization (WHO) guidelines was shown to be effective in reducing the odds of mortality in inpatients with PCR-confirmed seasonal influenza A(H3N2) after adjustment in a busy routine English hospital setting. Our results highlight the importance of hospitals complying with relevant guidelines for prompt seasonal influenza PCR testing and ensuring standard oseltamivir treatment to all PCR-confirmed cases of seasonal influenza.

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2019-10-30
2024-04-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.44.1900087
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Influenza-associated mortality in hospital care: a retrospective cohort study of risk factors and impact of oseltamivir in an English teaching hospital, 2016 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Mark+Reacher&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reacher Mark</a>, <a href="/search?value1=Ben+Warne&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Warne Ben</a>, <a href="/search?value1=Lucy+Reeve&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reeve Lucy</a>, <a href="/search?value1=Neville+Q.+Verlander&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Verlander Neville Q.</a>, <a href="/search?value1=Nicholas+K.+Jones&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jones Nicholas K.</a>, <a href="/search?value1=Kyriaki+Ranellou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ranellou Kyriaki</a>, <a href="/search?value1=Silvana+Christou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Christou Silvana</a>, <a href="/search?value1=Callum+Wright&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wright Callum</a>, <a href="/search?value1=Saher+Choudhry&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Choudhry Saher</a>, <a href="/search?value1=Maria+Zambon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zambon Maria</a>, <a href="/search?value1=Clare+Sander&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sander Clare</a>, <a href="/search?value1=Hongyi+Zhang&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zhang Hongyi</a>, <a href="/search?value1=Hamid+Jalal&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jalal Hamid</a></span>. Influenza-associated mortality in hospital care: a retrospective cohort study of risk factors and impact of oseltamivir in an English teaching hospital, 2016 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(44):pii=1900087. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900087" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900087</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 26 Jan 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 04 Sept 2019 </span> </p>
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