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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 Publisher Pubmed



Venkatesan S1 ; Myles PR1 ; Bolton KJ2 ; Muthuri SG3 ; Al Khuwaitir T4 ; Anovadiya AP5 ; Azzizbaumgartner E6 ; Bajjou T7 ; Bassetti M8 ; Beovic B9 ; Bertisch B10 ; Bonmarin I11 ; Booy R12 ; Borjaaburto VH13 Show All Authors
Authors
  1. Venkatesan S1
  2. Myles PR1
  3. Bolton KJ2
  4. Muthuri SG3
  5. Al Khuwaitir T4
  6. Anovadiya AP5
  7. Azzizbaumgartner E6
  8. Bajjou T7
  9. Bassetti M8
  10. Beovic B9
  11. Bertisch B10
  12. Bonmarin I11
  13. Booy R12
  14. Borjaaburto VH13
  15. Burgmann H14
  16. Cao B15
  17. Carratala J16
  18. Chinbayar T17
  19. Cilloniz C18
  20. Denholm JT19
  21. Dominguez SR20
  22. Duarte PAD21
  23. Dubnovraz G22
  24. Fanella S23
  25. Gao Z24
  26. Gerardin P25, 26, 27
  27. Giannella M28, 29
  28. Gubbels S30
  29. Herberg J31
  30. Higuera Iglesias AL32
  31. Hoeger PH33
  32. Hu XY34
  33. Islam QT35
  34. Jimenez MF36
  35. Keijzers G37
  36. Khalili H38
  37. Kusznierz G39
  38. Kuzman I40
  39. Langenegger E41
  40. Lankarani KB42
  41. Leo YS43
  42. Libster RP44, 45, 46
  43. Linko R47
  44. Madanat F48
  45. Maltezos E49
  46. Mamun A50
  47. Manabe T51
  48. Metan G52
  49. Mickiene A53
  50. Mikic D54
  51. Mohn KGI55, 56
  52. Oliva ME57
  53. Ozkan M58
  54. Parekh D59
  55. Paul M60
  56. Rath BA61
  57. Refaey S62
  58. Rodriguez AH63
  59. Sertogullarindan B64
  60. Skretmagierlo J65
  61. Somer A66
  62. Talarek E67
  63. Tang JW68, 69, 70
  64. To K71
  65. Tran D72
  66. Uyeki TM6
  67. Vaudry W73
  68. Vidmar T74
  69. Zarogoulidis P75
  70. Nguyenvantam JS1

Source: The Journal of infectious diseases Published:2020


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. © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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