Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia.

• Type of Material: Article
• Authors: Ikwo K. Oboho, Centers for Disease Control and Prevention; Anna Bramley, Centers for Disease Control and Prevention; Lyn Finelli, Emory University; Alicia Fry, Centers for Disease Control and Prevention; Krow Ampofo, University of Utah; Sandra R. Arnold, Le Bonheur Children's Hospital; Wesley H. Self, Vanderbilt University; Derek J. Williams, Vanderbilt University; D. Mark Courtney, Northwestern University; Yuwei Zhu, Vanderbilt University; Evan Anderson, Emory University; Carlos G. Grijalva, Vanderbilt University; Jonathan A. McCullers, Le Bonheur Children's Hospital; Richard G. Wunderink, Northwestern University; Andrew T. Pavia, University of Utah; Katherine Edwards, Emory University; Seema Jain, Centers for Disease Control and Prevention
• Language: English
• Date: 2017
• Publisher: Oxford University Press (OUP)
• Publication Version: Final Published Version
• Copyright Statement: This work is written by (a) US Government employee(s) and is in the public domain in the US.
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofw254
• Title of Journal or Parent Work: Open Forum Infectious Diseases
• ISSN: 2328-8957
• Volume: 4
• Issue: 1
• Start Page: ofw254
• End Page: ofw254
• Grant/Funding Information: This work was funded by the Centers for Disease Control and Prevention.; 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.; D. J. W., J. A. M., and Y. Z. received grant support through their institutions from CDC.; D. M. C. received grant support through his institution from CDC.; E. J. A. received grant support from MedImmune, editorial support for an unrelated study from Roche, and consulting fees from AbbVie.; K. M. E. served on a data and safety monitoring board for Novartis for which her institution received fees.; C. G. G. received grant support through his institution from CDC and consulting fees from Pfizer.; S. R. A received grant support through her institution from CDC GlaxoSmithKline.; 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.; 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. 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.
• Keywords: influenza; community-acquired pneumonia; oseltamivir.
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

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.