TY - JOUR
T1 - Oseltamivir use among children and adults hospitalized with community-acquired pneumonia
AU - Oboho, Ikwo K.
AU - Bramley, Anna
AU - Finelli, Lyn
AU - Fry, Alicia
AU - Ampofo, Krow
AU - Arnold, Sandra R.
AU - Self, Wesley H.
AU - Williams, Derek J.
AU - Mark Courtney, D.
AU - Zhu, Yuwei
AU - Anderson, Evan J.
AU - Grijalva, Carlos G.
AU - McCullers, Jonathan A.
AU - Wunderink, Richard G.
AU - Pavia, Andrew T.
AU - Edwards, Kathryn M.
AU - Jain, Seema
N1 - Funding Information:
We thank the patients who graciously consented to participate in this study and all members of the Etiology of Pneumonia in the Community (EPIC) Study Team for their contributions. This work was funded by the Centers for Disease Control and Prevention. W. H. S. received fees for serving on an advisory board from BioFire Diagnostics, and Venaxis, grant support through his institution from bioMérieux, Affinium Pharmaceuticals, Astute Medical, Thermo Fisher, Pfizer, Rapid Pathogen Screening, Venaxis, BioAegis Inc and Sphingotec GmbH, and consulting fees from Abbott Point of Care, and Cempra Pharmaceuticals. R.G.W. received consulting fees from bioMerieux and GenMark, grant support through his institution from bioMerieux, and fees for serving on a data safety monitoring board from Vertex. C. G. G. received grant support through his institution from CDC and consulting fees from Pfizer. E. J. A. received grant support from MedImmune, editorial support for an unrelated study from Roche, and consulting fees from AbbVie. D. M. C. received grant support through his institution from CDC. S. R. A received grant support through her institution from CDC GlaxoSmithKline. K. A. received grant support through his institution from CDC, receiving fees through his institution from GlaxoSmithKline, Cubist Pharmaceuticals, and National Institutes of Health for the enrollment of patients in other studies. A. T. P. received grant support through his institution from CDC, National Institute of Allergy and Infectious Diseases and BioFire, received fees for serving on a data safety monitory board for Alios Pharmaceutical, received fees for the preparation of educational material from Medscape, and royalties from Antimicrobial Therapy. K. M. E. served on a data and safety monitoring board for Novartis for which her institution received fees. D. J. W., J. A. M., and Y. Z. received grant support through their institutions from CDC. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Community-acquired pneumonia
KW - Influenza
KW - Oseltamivir
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U2 - 10.1093/oid/ofw254
DO - 10.1093/oid/ofw254
M3 - Article
AN - SCOPUS:85014323309
SN - 2328-8957
VL - 4
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 1
M1 - ofw254
ER -