Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia
Ikwo K Oboho1,2, Anna Bramley1, Lyn Finelli1
1Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Oseltamivir treatment for hospitalized community-acquired pneumonia (CAP) patients during influenza season was infrequent. Treatment was linked to influenza testing, severe illness, and specific hospitals, indicating a need for improved clinician education and empirical treatment strategies.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pharmacology
Background:
- Limited data exists on oseltamivir use in hospitalized community-acquired pneumonia (CAP) patients.
- Influenza is a significant cause of CAP, necessitating effective antiviral treatment.
Purpose of the Study:
- To investigate the utilization and associated factors of oseltamivir treatment in hospitalized CAP patients during influenza seasons.
- To identify patient and hospital-level factors influencing oseltamivir prescription.
Main Methods:
- A retrospective study included CAP patients hospitalized across six hospitals during 2010-2012 influenza seasons.
- Logistic regression analysis was employed to determine factors associated with oseltamivir treatment.
Main Results:
- Oseltamivir was administered to 5% of children and 14% of adults with CAP.
- Among patients with positive influenza tests, 64% of children and 77% of adults received oseltamivir.
- Factors associated with oseltamivir treatment included clinician-ordered testing, intensive care unit (ICU) admission, specific hospitals, and demographic characteristics.
Conclusions:
- Oseltamivir treatment rates for hospitalized CAP patients during influenza season were moderate.
- Clinician-ordered testing, indicators of severe illness (ICU admission), and hospital site were significantly associated with oseltamivir use.
- Enhanced clinician education is recommended to improve influenza diagnosis, testing, and empirical oseltamivir treatment in hospitalized CAP patients.
Background:
Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited.
Methods:
Patients hospitalized with CAP at 6 hospitals during the 2010-2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression.
Results:
Oseltamivir treatment was provided to 89 of 1627 (5%) children (<18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36-4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47-5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27-3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16-1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64-15.12), hospitals D and E (aOR, 3.46-5.11; 95% CI, 1.75-11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18-3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34-3.13).
Conclusions:
Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.
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