In:
Influenza and Other Respiratory Viruses, Wiley, Vol. 10, No. 3 ( 2016-05), p. 192-204
Abstract:
The impact of neuraminidase inhibitors ( NAI s) on influenza‐related pneumonia ( IRP ) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 ( n = 20 021) or clinically diagnosed ( n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP . Odds ratios ( OR ) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results Of 20 634 included participants, 5978 (29·0%) had IRP ; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP , early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP . However, in patients who developed IRP , early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.
Type of Medium:
Online Resource
ISSN:
1750-2640
,
1750-2659
DOI:
10.1111/irv.2016.10.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2272349-3
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