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2017-02-12Zeitschriftenartikel DOI: 10.1093/cid/cix127
Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis
dc.contributor.authorVenkatesan, Sudhir
dc.contributor.authorMyles, Puja R.
dc.contributor.authorLeonardi-Bee, Jo
dc.contributor.authorMuthuri, Stella G.
dc.contributor.authorMasri, Malak Al
dc.contributor.authorAndrews, Nick
dc.contributor.authorBantar, Carlos
dc.contributor.authorDubnov-Raz, Gal
dc.contributor.authorGérardin, Patrick
dc.contributor.authorKoay, Evelyn S. C.
dc.contributor.authorLoh, Tze Ping
dc.contributor.authorMemish, Ziad
dc.contributor.authorMiller, Elizabeth
dc.contributor.authorOliva, Maria E.
dc.contributor.authorRath, Barbara A.
dc.contributor.authorSchweiger, Brunhilde
dc.contributor.authorTang, Julian W.
dc.contributor.authorTran, Dat
dc.contributor.authorVidmar, Tjasa
dc.contributor.authorWaight, Pauline A.
dc.contributor.authorNguyen-Van-Tam, Jonathan S.
dc.date.accessioned2018-05-07T20:09:15Z
dc.date.available2018-05-07T20:09:15Z
dc.date.created2017-06-27
dc.date.issued2017-02-12none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reW55uhVSj7vM/PDF/29kayh6BeiknQ.pdf
dc.identifier.urihttp://edoc.rki.de/176904/2683
dc.description.abstractBackground: While evidence exists to support the effectiveness of neuraminidase inhibitors (NAIs) in reducing mortality when given to hospitalized patients with A(H1N1)pdm09 virus infection, the impact of outpatient treatment on hospitalization has not been clearly established. We investigated the impact of outpatient NAI treatment on subsequent hospitalization in patients with A(H1N1)pdm09 virus infection. Methods: We assembled general community and outpatient data from 9 clinical centers in different countries collected between January 2009 and December 2010. We standardized data from each study center to create a pooled dataset and then used mixed-effects logistic regression modeling to determine the effect of NAI treatment on hospitalization. We adjusted for NAI treatment propensity and preadmission antibiotic use, including “study center” as a random intercept to account for differences in baseline hospitalization rate between centers. Results: We included 3376 patients with influenza A(H1N1)pdm09, of whom 3085 (91.4%) had laboratory-confirmed infection. Eight hundred seventy-three patients (25.8%) received outpatient or community-based NAI treatment, 928 of 2395 (38.8%) with available data had dyspnea or respiratory distress, and hospitalizations occurred in 1705 (50.5%). After adjustment for preadmission antibiotics and NAI treatment propensity, preadmission NAI treatment was associated with decreased odds of hospital admission compared to no NAI treatment (adjusted odds ratio, 0.24; 95% confidence interval, 0.20–0.30). Conclusions: In a population with confirmed or suspected A(H1N1)pdm09 and at high risk of hospitalization, outpatient or community-based NAI treatment significantly reduced the likelihood of requiring hospital admission. These data suggest that community patients with severe influenza should receive NAI treatment.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionskrankheiten / Erreger
dc.subjectpandemiceng
dc.subjectinfluenzaeng
dc.subjectneuraminidase inhibitorseng
dc.subjectindividual participant data metaanalyseseng
dc.subjecthospitalizationeng
dc.subject.ddc610 Medizin
dc.titleImpact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10053114
dc.identifier.doi10.1093/cid/cix127
dc.identifier.doihttp://dx.doi.org/10.25646/2608
local.edoc.container-titleClinical Infectious Diseases
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix127
local.edoc.container-publisher-nameOxford University Press
local.edoc.container-volume64
local.edoc.container-issue10
local.edoc.container-year2017

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