Trends in antiviral therapy of adults hospitalized with influenza in Canada since the end of the 2009 pandemic
Identifieur interne : 001785 ( Ncbi/Checkpoint ); précédent : 001784; suivant : 001786Trends in antiviral therapy of adults hospitalized with influenza in Canada since the end of the 2009 pandemic
Auteurs : Geoffrey Taylor [Canada] ; Robyn Mitchell [Canada] ; Rachel Fernandes [Canada] ; Allison Mcgeer [Canada] ; Charles Frenette [Canada] ; Kathryn N. Suh [Canada] ; Alice Wong [Canada] ; Kevin Katz [Canada] ; Krista Wilkinson [Canada] ; Barbara Amihod [Canada] ; Denise Gravel [Canada]Source :
- Antimicrobial Resistance and Infection Control [ 2047-2994 ] ; 2014.
Abstract
Multiple observational studies have associated antiviral treatment of patients hospitalized with influenza with improved outcome, including reduced mortality. During the 2009–2010 H1N1 pandemic increased use of antiviral treatment of hospital patients was reported. We have carried out prospective surveillance for influenza in patients in a large network of Canadian hospitals since 2006. We wished to assess trends in antiviral use in the two seasons (2010–2011 and 2011–2012) since the end of the pandemic.
Adults (>16 years) testing positive for influenza at the time of or during admission to participating Canadian hospitals were prospectively reviewed. In 2009–2010 there were 1132 confirmed cases, 1107 in 2010–2011 and 631 in 2011–2012. Information on antiviral therapy was available in >95% in each year. Rising to 89.6% in 2009, the proportion of adult patients treated with antiviral therapy fell to 79.9% and 65.7% in the two subsequent seasons (p < 0.001). Oseltamivir was the antiviral agent used in >98% of cases in each year. The median time from onset of symptoms to initiation of antiviral therapy was three days. The treatment proportion fell across all age groups, co-morbid conditions and disease severity.
Despite evidence for benefit of antiviral therapy, and clinical practice guidelines recommending treatment of this population, antiviral therapy of Canadian adults hospitalized with influenza has progressively fallen in the two seasons since the end of the 2009–2010 influenza pandemic.
Url:
DOI: 10.1186/2047-2994-3-2
PubMed: 24405855
PubMed Central: 3895698
Affiliations:
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Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Fernandes, Rachel" sort="Fernandes, Rachel" uniqKey="Fernandes R" first="Rachel" last="Fernandes">Rachel Fernandes</name><affiliation wicri:level="1"><nlm:aff id="I2">Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation wicri:level="1"><nlm:aff id="I3">Mount Sinai Hospital, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Frenette, Charles" sort="Frenette, Charles" uniqKey="Frenette C" first="Charles" last="Frenette">Charles Frenette</name><affiliation wicri:level="1"><nlm:aff id="I4">McGill University Health Centre, Montreal, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>McGill University Health Centre, Montreal, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Suh, Kathryn N" sort="Suh, Kathryn N" uniqKey="Suh K" first="Kathryn N" last="Suh">Kathryn N. Suh</name><affiliation wicri:level="1"><nlm:aff id="I5">The Ottawa Hospital, Ottawa, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Ottawa Hospital, Ottawa, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Wong, Alice" sort="Wong, Alice" uniqKey="Wong A" first="Alice" last="Wong">Alice Wong</name><affiliation wicri:level="1"><nlm:aff id="I6">Royal University Hospital, Saskatoon, Saskatchewan, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Royal University Hospital, Saskatoon, Saskatchewan</wicri:regionArea><wicri:noRegion>Saskatchewan</wicri:noRegion></affiliation></author><author><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><affiliation wicri:level="1"><nlm:aff id="I7">North York General Hospital, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Wilkinson, Krista" sort="Wilkinson, Krista" uniqKey="Wilkinson K" first="Krista" last="Wilkinson">Krista Wilkinson</name><affiliation wicri:level="1"><nlm:aff id="I2">Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Amihod, Barbara" sort="Amihod, Barbara" uniqKey="Amihod B" first="Barbara" last="Amihod">Barbara Amihod</name><affiliation wicri:level="1"><nlm:aff id="I8">Jewish General Hospital, Montreal, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Jewish General Hospital, Montreal, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Gravel, Denise" sort="Gravel, Denise" uniqKey="Gravel D" first="Denise" last="Gravel">Denise Gravel</name><affiliation wicri:level="1"><nlm:aff id="I2">Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><series><title level="j">Antimicrobial Resistance and Infection Control</title><idno type="eISSN">2047-2994</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Multiple observational studies have associated antiviral treatment of patients hospitalized with influenza with improved outcome, including reduced mortality. During the 2009–2010 H1N1 pandemic increased use of antiviral treatment of hospital patients was reported. We have carried out prospective surveillance for influenza in patients in a large network of Canadian hospitals since 2006. We wished to assess trends in antiviral use in the two seasons (2010–2011 and 2011–2012) since the end of the pandemic.</p></sec><sec><title>Findings</title><p>Adults (>16 years) testing positive for influenza at the time of or during admission to participating Canadian hospitals were prospectively reviewed. In 2009–2010 there were 1132 confirmed cases, 1107 in 2010–2011 and 631 in 2011–2012. Information on antiviral therapy was available in >95% in each year. Rising to 89.6% in 2009, the proportion of adult patients treated with antiviral therapy fell to 79.9% and 65.7% in the two subsequent seasons (p < 0.001). Oseltamivir was the antiviral agent used in >98% of cases in each year. The median time from onset of symptoms to initiation of antiviral therapy was three days. The treatment proportion fell across all age groups, co-morbid conditions and disease severity.</p></sec><sec><title>Conclusion</title><p>Despite evidence for benefit of antiviral therapy, and clinical practice guidelines recommending treatment of this population, antiviral therapy of Canadian adults hospitalized with influenza has progressively fallen in the two seasons since the end of the 2009–2010 influenza pandemic.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Green, Ka" uniqKey="Green K">KA Green</name></author><author><name sortKey="Plevneshi, A" uniqKey="Plevneshi A">A Plevneshi</name></author><author><name sortKey="Shigayeva, A" uniqKey="Shigayeva A">A Shigayeva</name></author><author><name sortKey="Siddiqi, N" uniqKey="Siddiqi N">N Siddiqi</name></author><author><name sortKey="Raboud, J" uniqKey="Raboud J">J Raboud</name></author><author><name sortKey="Low, D" uniqKey="Low D">D Low</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, N" uniqKey="Lee N">N Lee</name></author><author><name sortKey="Choi, Kw" uniqKey="Choi K">KW Choi</name></author><author><name sortKey="Chan, Pks" uniqKey="Chan P">PKS Chan</name></author><author><name sortKey="Hui, Dsc" uniqKey="Hui D">DSC Hui</name></author><author><name sortKey="Lui, Gcy" uniqKey="Lui G">GCY Lui</name></author><author><name sortKey="Wong, Bck" uniqKey="Wong B">BCK Wong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louie, Jk" uniqKey="Louie J">JK Louie</name></author><author><name sortKey="Yang, S" uniqKey="Yang S">S Yang</name></author><author><name sortKey="Acosta, M" uniqKey="Acosta M">M Acosta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Muthuri, Sg" uniqKey="Muthuri S">SG Muthuri</name></author><author><name sortKey="Myles, Pr" uniqKey="Myles P">PR Myles</name></author><author><name sortKey="Venkatesan, S" uniqKey="Venkatesan S">S Venkatesan</name></author><author><name sortKey="Leonardi Bee, J" uniqKey="Leonardi Bee J">J Leonardi-Bee</name></author><author><name sortKey="Nguyen Van Tam, Js" uniqKey="Nguyen Van Tam J">JS Nguyen-Van-Tam</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Harper, Sa" uniqKey="Harper S">SA Harper</name></author><author><name sortKey="Bradley, Js" uniqKey="Bradley J">JS Bradley</name></author><author><name sortKey="Englund, Ja" uniqKey="Englund J">JA Englund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aoki, Fy" uniqKey="Aoki F">FY Aoki</name></author><author><name sortKey="Allen, Ud" uniqKey="Allen U">UD Allen</name></author><author><name sortKey="Stiver, Hg" uniqKey="Stiver H">HG Stiver</name></author><author><name sortKey="Evans, Ga" uniqKey="Evans G">GA Evans</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Doshi, S" uniqKey="Doshi S">S Doshi</name></author><author><name sortKey="Kamimoto, L" uniqKey="Kamimoto L">L Kamimoto</name></author><author><name sortKey="Finelli, L" uniqKey="Finelli L">L Finelli</name></author><author><name sortKey="Perez, A" uniqKey="Perez A">A Perez</name></author><author><name sortKey="Reingold, A" uniqKey="Reingold A">A Reingold</name></author><author><name sortKey="Gershman, K" uniqKey="Gershman K">K Gershman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wilkinson, K" uniqKey="Wilkinson K">K Wilkinson</name></author><author><name sortKey="Mitchell, R" uniqKey="Mitchell R">R Mitchell</name></author><author><name sortKey="Taylor, G" uniqKey="Taylor G">G Taylor</name></author><author><name sortKey="Amihod, B" uniqKey="Amihod B">B Amihod</name></author><author><name sortKey="Frenette, C" uniqKey="Frenette C">C Frenette</name></author><author><name sortKey="Gravel, D" uniqKey="Gravel D">D Gravel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aoki, F" uniqKey="Aoki F">F Aoki</name></author><author><name sortKey="Hayden, F" uniqKey="Hayden F">F Hayden</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garg, S" uniqKey="Garg S">S Garg</name></author><author><name sortKey="Chaves, S" uniqKey="Chaves S">S Chaves</name></author><author><name sortKey="Perez, A" uniqKey="Perez A">A Perez</name></author><author><name sortKey="D Ello, T" uniqKey="D Ello T">T D’Mello</name></author><author><name sortKey="Gersham, K" uniqKey="Gersham K">K Gersham</name></author><author><name sortKey="Meek, J" uniqKey="Meek J">J Meek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jefferson, T" uniqKey="Jefferson T">T Jefferson</name></author><author><name sortKey="Jones, M" uniqKey="Jones M">M Jones</name></author><author><name sortKey="Doshi, P" uniqKey="Doshi P">P Doshi</name></author><author><name sortKey="Del Mar, C" uniqKey="Del Mar C">C Del Mar</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Taylor, Geoffrey" sort="Taylor, Geoffrey" uniqKey="Taylor G" first="Geoffrey" last="Taylor">Geoffrey Taylor</name></noRegion><name sortKey="Amihod, Barbara" sort="Amihod, Barbara" uniqKey="Amihod B" first="Barbara" last="Amihod">Barbara Amihod</name><name sortKey="Fernandes, Rachel" sort="Fernandes, Rachel" uniqKey="Fernandes R" first="Rachel" last="Fernandes">Rachel Fernandes</name><name sortKey="Frenette, Charles" sort="Frenette, Charles" uniqKey="Frenette C" first="Charles" last="Frenette">Charles Frenette</name><name sortKey="Gravel, Denise" sort="Gravel, Denise" uniqKey="Gravel D" first="Denise" last="Gravel">Denise Gravel</name><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Mitchell, Robyn" sort="Mitchell, Robyn" uniqKey="Mitchell R" first="Robyn" last="Mitchell">Robyn Mitchell</name><name sortKey="Suh, Kathryn N" sort="Suh, Kathryn N" uniqKey="Suh K" first="Kathryn N" last="Suh">Kathryn N. Suh</name><name sortKey="Wilkinson, Krista" sort="Wilkinson, Krista" uniqKey="Wilkinson K" first="Krista" last="Wilkinson">Krista Wilkinson</name><name sortKey="Wong, Alice" sort="Wong, Alice" uniqKey="Wong A" first="Alice" last="Wong">Alice Wong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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