Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection.

Bibliographic Details
Title: Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection.
Authors: Venkatesan, Sudhir, Myles, Puja R, Bolton, Kirsty J, Muthuri, Stella G, Khuwaitir, Tarig Al, Anovadiya, Ashish P, Azziz-Baumgartner, Eduardo, Bajjou, Tahar, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H, Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Chinbayar, Tserendorj, Cilloniz, Catia, Denholm, Justin T
Source: Journal of Infectious Diseases; 2/1/2020, Vol. 221 Issue 3, p356-366, 11p
Subject Terms: LENGTH of stay in hospitals, VIRUS diseases, INFLUENZA, TREATMENT effectiveness, NEURAMINIDASE, META-analysis, ANTIBIOTICS, INFLUENZA epidemiology, RESEARCH, ADRENOCORTICAL hormones, RESEARCH methodology, ANTIVIRAL agents, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, GLYCOSIDASES, EPIDEMICS, ENZYME inhibitors, INFLUENZA A virus, H1N1 subtype, PHARMACODYNAMICS, CHEMICAL inhibitors
Abstract: Background: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear.Methods: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded.Results: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS.Conclusions: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
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ISSN:00221899
DOI:10.1093/infdis/jiz152
Published in:Journal of Infectious Diseases
Language:English