A NEW study demonstrates that initiating oseltamivir treatment on the day of hospital admission significantly reduces the severity of illness and risk of death in adults hospitalized with influenza.
Conducted across 24 USA hospitals between October 2022–July 2023, the study analyzed 840 hospitalized adults aged 18 years or older who tested positive for influenza. Of these, 415 patients (49%) began oseltamivir treatment on the day of admission, while 425 patients (51%) either received delayed treatment or were not treated with oseltamivir. Researchers used multivariable models to adjust for differences in baseline disease severity, age, sex, vaccination status, and hospital site to isolate the effects of early treatment.
The findings reveal that patients who received early oseltamivir treatment experienced significantly lower peak pulmonary disease severity (adjusted odds ratio [aOR] of 0.60; 95% CI: 0.49–0.72). Early treatment was also associated with a 76% reduction in the odds of requiring intensive care unit admission (aOR: 0.24, 95% CI: 0.13–0.47) and a 60% lower likelihood of needing acute kidney replacement therapy or vasopressors to manage organ failure (aOR: 0.40, 95% CI: 0.22–0.67). Furthermore, early treatment reduced the risk of in-hospital death by 64% (aOR: 0.36, 95% CI: 0.18–0.72).
The data reinforce the urgency of initiating oseltamivir immediately upon admission to reduce risk of disease progression, including pulmonary and extrapulmonary organ failure and death. The authors emphasized that early intervention could be life-saving for many hospitalized patients with influenza.
Ada Enesco, EMJ
Reference
Lewis NM et al. Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study. Clin Infect Dis. 2024; DOI:10.1093/cid/ciae584.
