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PLoS One. 2015 Mar 25;10(3):e0121952. doi: 10.1371/journal.pone.0121952. eCollection 2015.

Antiviral treatment among older adults hospitalized with influenza, 2006-2012.

Author information

1
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
2
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Mid-South Geriatric Research Education and Clinical Center, VA TN Valley Health Care System, Nashville, Tennessee, United States of America.
3
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
4
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
5
Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
6
Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
7
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
8
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.

Abstract

OBJECTIVE:

To describe antiviral use among older, hospitalized adults during six influenza seasons (2006-2012) in Davidson County, Tennessee, USA.

METHODS:

Among adults ≥50 years old hospitalized with symptoms of respiratory illness or non-localizing fever, we collected information on provider-initiated influenza testing and nasal/throat swabs for influenza by RT-PCR in a research laboratory, and calculated the proportion treated with antivirals.

RESULTS:

We enrolled 1753 adults hospitalized with acute respiratory illness. Only 26% (457/1753) of enrolled patients had provider-initiated influenza testing. Thirty-eight patients had a positive clinical laboratory test, representing 2.2% of total patients and 8.3% of tested patients. Among the 38 subjects with clinical laboratory-confirmed influenza, 26.3% received antivirals compared to only 4.5% of those with negative clinical influenza tests and 0.7% of those not tested (p<0.001). There were 125 (7.1%) patients who tested positive for influenza in the research laboratory. Of those with research laboratory-confirmed influenza, 0.9%, 2.7%, and 2.8% received antivirals (p=.046) during pre-pandemic, pandemic, and post-pandemic influenza seasons, respectively. Both research laboratory-confirmed influenza (adjusted odds ratio [AOR] 3.04 95%CI 1.26-7.35) and clinical laboratory-confirmed influenza (AOR 3.05, 95%CI 1.07-8.71) were independently associated with antiviral treatment. Severity of disease, presence of a high-risk condition, and symptom duration were not associated with antiviral use.

CONCLUSIONS:

In urban Tennessee, antiviral use was low in patients recognized to have influenza by the provider as well as those unrecognized to have influenza. The use of antivirals remained low despite recommendations to treat all hospitalized patients with confirmed or suspected influenza.

PMID:
25807314
PMCID:
PMC4373943
DOI:
10.1371/journal.pone.0121952
[Indexed for MEDLINE]
Free PMC Article

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