Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection

Geert H. Groeneveld; Sierk D. Marbus; Noor Ismail; Jutte J.C. de Vries; Peter Schneeberger; Jan Jelrik Oosterheert; Jaap T. van Dissel; Mark G.J. de Boer

doi:10.1016/j.ijantimicag.2020.106155

Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection

Geert H. Groeneveld^*, Sierk D. Marbus, Noor Ismail, Jutte J.C. de Vries, Peter Schneeberger, Jan Jelrik Oosterheert, Jaap T. van Dissel, Mark G.J. de Boer

^*Corresponding author for this work

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Abstract

OBJECTIVES: The benefit of oseltamivir treatment in patients admitted with influenza virus infection and the design of studies addressing this issue have been questioned extensively. As the burden of influenza disease is substantial and oseltamivir treatment is biologically plausible, this study assessed the clinical benefit of oseltamivir treatment in adult patients admitted with severe seasonal influenza virus infection in daily practice.

PATIENTS AND METHODS: A multi-centre, retrospective cohort study was conducted to compare the effectiveness of treatment with and without oseltamivir <48 h after admission in patients admitted with laboratory-confirmed influenza virus infection in three large hospitals in the Netherlands. Propensity score matching was used to compare clinically relevant outcome variables.

RESULTS: In total, 390 patients were included in this study, of whom 80% had comorbidities. Thirty-day mortality, as well as the composite endpoint of 30-day mortality or intensive care unit admission >48 h after admission, were reduced by 9% (P=0.04) and 11% (P=0.02), respectively. Length of hospital stay and in-hospital mortality rates all showed a trend towards reduction. The median duration between symptom onset and initiation of treatment was 3 days.

CONCLUSIONS: This study supports that, in daily practice, patients admitted with influenza virus infection should be treated with oseltamivir within 48 h of admission, even if they have had complaints for >48 h.

Original language	English
Article number	106155
Pages (from-to)	1-7
Journal	International Journal of Antimicrobial Agents
Volume	56
Issue number	5
DOIs	https://doi.org/10.1016/j.ijantimicag.2020.106155
Publication status	Published - Nov 2020

Keywords

Complications
Influenza
Mortality
Oseltamivir
Treatment

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10.1016/j.ijantimicag.2020.106155

1-s2.0-S092485792030354X-mainFinal published version, 590 KBLicence: CC BY

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Groeneveld, G. H., Marbus, S. D., Ismail, N., de Vries, J. J. C., Schneeberger, P., Oosterheert, J. J., van Dissel, J. T., & de Boer, M. G. J. (2020). Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection. International Journal of Antimicrobial Agents, 56(5), 1-7. Article 106155. https://doi.org/10.1016/j.ijantimicag.2020.106155

@article{654161de96674532820cb3094e6915fa,

title = "Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection",

abstract = "OBJECTIVES: The benefit of oseltamivir treatment in patients admitted with influenza virus infection and the design of studies addressing this issue have been questioned extensively. As the burden of influenza disease is substantial and oseltamivir treatment is biologically plausible, this study assessed the clinical benefit of oseltamivir treatment in adult patients admitted with severe seasonal influenza virus infection in daily practice.PATIENTS AND METHODS: A multi-centre, retrospective cohort study was conducted to compare the effectiveness of treatment with and without oseltamivir <48 h after admission in patients admitted with laboratory-confirmed influenza virus infection in three large hospitals in the Netherlands. Propensity score matching was used to compare clinically relevant outcome variables.RESULTS: In total, 390 patients were included in this study, of whom 80% had comorbidities. Thirty-day mortality, as well as the composite endpoint of 30-day mortality or intensive care unit admission >48 h after admission, were reduced by 9% (P=0.04) and 11% (P=0.02), respectively. Length of hospital stay and in-hospital mortality rates all showed a trend towards reduction. The median duration between symptom onset and initiation of treatment was 3 days.CONCLUSIONS: This study supports that, in daily practice, patients admitted with influenza virus infection should be treated with oseltamivir within 48 h of admission, even if they have had complaints for >48 h.",

keywords = "Complications, Influenza, Mortality, Oseltamivir, Treatment",

author = "Groeneveld, {Geert H.} and Marbus, {Sierk D.} and Noor Ismail and {de Vries}, {Jutte J.C.} and Peter Schneeberger and Oosterheert, {Jan Jelrik} and {van Dissel}, {Jaap T.} and {de Boer}, {Mark G.J.}",

note = "Funding Information: Funding: This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW) (Grant No. 204000001); the Virgo Consortium, funded by the Dutch Government (Grant No. FES0908); and the Netherlands Genomics Initiative (Grant No. 050–060-452). The funding sources had no role in the design of this study, and did not have any role during its execution, analyses, interpretation of the data or decision to submit results. Funding Information: The authors wish to thank the pharmacy departments of Jeroen Bosch Hospital, University Medical Centre Utrecht and Leiden University Medical Centre for providing data on oseltamivir treatment. Funding: This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW) (Grant No. 204000001); the Virgo Consortium, funded by the Dutch Government (Grant No. FES0908); and the Netherlands Genomics Initiative (Grant No. 050–060-452). The funding sources had no role in the design of this study, and did not have any role during its execution, analyses, interpretation of the data or decision to submit results. Competing interests: None declared. Ethical approval: This study was approved by each hospital's ethical review board (G16.054). Publisher Copyright: {\textcopyright} 2020 The Authors",

year = "2020",

month = nov,

doi = "10.1016/j.ijantimicag.2020.106155",

language = "English",

volume = "56",

pages = "1--7",

journal = "International Journal of Antimicrobial Agents",

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publisher = "Elsevier",

number = "5",

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Groeneveld, GH, Marbus, SD, Ismail, N, de Vries, JJC, Schneeberger, P, Oosterheert, JJ, van Dissel, JT & de Boer, MGJ 2020, 'Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection', International Journal of Antimicrobial Agents, vol. 56, no. 5, 106155, pp. 1-7. https://doi.org/10.1016/j.ijantimicag.2020.106155

TY - JOUR

T1 - Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection

AU - Groeneveld, Geert H.

AU - Marbus, Sierk D.

AU - Ismail, Noor

AU - de Vries, Jutte J.C.

AU - Schneeberger, Peter

AU - Oosterheert, Jan Jelrik

AU - van Dissel, Jaap T.

AU - de Boer, Mark G.J.

N1 - Funding Information: Funding: This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW) (Grant No. 204000001); the Virgo Consortium, funded by the Dutch Government (Grant No. FES0908); and the Netherlands Genomics Initiative (Grant No. 050–060-452). The funding sources had no role in the design of this study, and did not have any role during its execution, analyses, interpretation of the data or decision to submit results. Funding Information: The authors wish to thank the pharmacy departments of Jeroen Bosch Hospital, University Medical Centre Utrecht and Leiden University Medical Centre for providing data on oseltamivir treatment. Funding: This work was supported by the Netherlands Organisation for Health Research and Development (ZonMW) (Grant No. 204000001); the Virgo Consortium, funded by the Dutch Government (Grant No. FES0908); and the Netherlands Genomics Initiative (Grant No. 050–060-452). The funding sources had no role in the design of this study, and did not have any role during its execution, analyses, interpretation of the data or decision to submit results. Competing interests: None declared. Ethical approval: This study was approved by each hospital's ethical review board (G16.054). Publisher Copyright: © 2020 The Authors

PY - 2020/11

Y1 - 2020/11

N2 - OBJECTIVES: The benefit of oseltamivir treatment in patients admitted with influenza virus infection and the design of studies addressing this issue have been questioned extensively. As the burden of influenza disease is substantial and oseltamivir treatment is biologically plausible, this study assessed the clinical benefit of oseltamivir treatment in adult patients admitted with severe seasonal influenza virus infection in daily practice.PATIENTS AND METHODS: A multi-centre, retrospective cohort study was conducted to compare the effectiveness of treatment with and without oseltamivir <48 h after admission in patients admitted with laboratory-confirmed influenza virus infection in three large hospitals in the Netherlands. Propensity score matching was used to compare clinically relevant outcome variables.RESULTS: In total, 390 patients were included in this study, of whom 80% had comorbidities. Thirty-day mortality, as well as the composite endpoint of 30-day mortality or intensive care unit admission >48 h after admission, were reduced by 9% (P=0.04) and 11% (P=0.02), respectively. Length of hospital stay and in-hospital mortality rates all showed a trend towards reduction. The median duration between symptom onset and initiation of treatment was 3 days.CONCLUSIONS: This study supports that, in daily practice, patients admitted with influenza virus infection should be treated with oseltamivir within 48 h of admission, even if they have had complaints for >48 h.

AB - OBJECTIVES: The benefit of oseltamivir treatment in patients admitted with influenza virus infection and the design of studies addressing this issue have been questioned extensively. As the burden of influenza disease is substantial and oseltamivir treatment is biologically plausible, this study assessed the clinical benefit of oseltamivir treatment in adult patients admitted with severe seasonal influenza virus infection in daily practice.PATIENTS AND METHODS: A multi-centre, retrospective cohort study was conducted to compare the effectiveness of treatment with and without oseltamivir <48 h after admission in patients admitted with laboratory-confirmed influenza virus infection in three large hospitals in the Netherlands. Propensity score matching was used to compare clinically relevant outcome variables.RESULTS: In total, 390 patients were included in this study, of whom 80% had comorbidities. Thirty-day mortality, as well as the composite endpoint of 30-day mortality or intensive care unit admission >48 h after admission, were reduced by 9% (P=0.04) and 11% (P=0.02), respectively. Length of hospital stay and in-hospital mortality rates all showed a trend towards reduction. The median duration between symptom onset and initiation of treatment was 3 days.CONCLUSIONS: This study supports that, in daily practice, patients admitted with influenza virus infection should be treated with oseltamivir within 48 h of admission, even if they have had complaints for >48 h.

KW - Complications

KW - Influenza

KW - Mortality

KW - Oseltamivir

KW - Treatment

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U2 - 10.1016/j.ijantimicag.2020.106155

DO - 10.1016/j.ijantimicag.2020.106155

M3 - Article

C2 - 32898685

AN - SCOPUS:85091505514

SN - 0924-8579

VL - 56

SP - 1

EP - 7

JO - International Journal of Antimicrobial Agents

JF - International Journal of Antimicrobial Agents

IS - 5

M1 - 106155

ER -

Effectiveness of oseltamivir in reduction of complications and 30-day mortality in severe seasonal influenza infection

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