Influenza Antiviral Prescribing for Outpatients With an Acute Respiratory Illness and at High Risk for Influenza-Associated Complications During 5 Influenza Seasons—United States, 2011–2016
Year: 2017
Type: article
Study design: Observational Study
Abstract: Background: Influenza causes millions of illnesses annually; certain groups are at higher risk for complications. Early antiviral treatment can reduce the risk of complications and is recommended for outpatients at increased risk. We describe antiviral prescribing among high-risk outpatients for 5 influenza seasons and explore factors that may influence prescribing. Methods: We analyzed antiviral prescription and clinical data for high-risk outpatients aged ≥6 months with an acute respiratory illness (ARI) and enrolled in the US Influenza Vaccine Effectiveness Network during the 2011-2012 through 2015-2016 influenza seasons. We obtained clinical information from interviews and electronic medical records and tested all enrollees for influenza with real-time reverse-transcription polymerase chain reaction (rRT-PCR). We calculated the number of patients with ARI that must be treated to treat 1 patient with influenza. Results: Among high-risk outpatients with ARI who presented to care within 2 days of symptom onset (early), 15% (718/4861) were prescribed an antiviral medication, including 472 of 1292 (37%) of those with rRT-PCR-confirmed influenza. Forty percent of high-risk outpatients with influenza presented to care early. Earlier presentation was associated with antiviral treatment (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.5-4.8), as was fever (OR, 3.2; 95% CI, 2.7-3.8), although 25% of high-risk outpatients with influenza were afebrile. Empiric treatment of 4 high-risk outpatients with ARI was needed to treat 1 patient with influenza. Conclusions: Influenza antiviral medications were infrequently prescribed for high-risk outpatients with ARI who would benefit most. Efforts to increase appropriate antiviral prescribing are needed to reduce influenza-associated complications.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/cix922
Institutions: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Epidemic Intelligence Service, Baylor Scott & White Health, Texas A&M University, University of Pittsburgh, Kaiser Permanente Washington Health Research Institute, University of Michigan, Marshfield Clinic Research Foundation
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
Awards: ANNUAL ESTIMATES OF INFLUENZA VACCINE EFFECTIVENESS AND EVALUATION OF IMMUNE RESPONSE IN A WISCONSIN POPULATION, University of Pittsburgh Clinical and Translational Science Institute, University of Pittsburgh Clinical and Translational Science Institute, PROSPECTIVE ANNUAL ESTIMATES OF INFLUENZA VACCINE EFFECTIVENESS AND BURDEN OF DISEASE, US INFLUENZA VACCINE EFFECTIVENESS NETWORK, OUTPATIENT VE FOR SEASONAL FLU, PANDEMIC FLU AND RSV IN A LARGE, DIVERSE NETWORK
OpenAlex ID: W2765121573