[Neuraminidase inhibitors in the general practice management of influenza: who prescribe them, when and with which results?].
OBJECTIVE
To describe in real-life conditions the flu therapeutic management, motivations to prescribe or not NAI (General Practitioners' (GPs) characteristics, decisional factors) and treated patients' course.


METHODS
A prospective, longitudinal, pharmacoepidemiological study involved 305 GPs in France during 2002-2003 winter epidemic peak. All patients>or=1 year old, with a clinical diagnostic of flu were included.


RESULTS
One hundred and eighty-five GPs (150 NAI prescribing and 30 non-prescribing physicians) have included at least 1 patient. Prescribing physicians were the best informed on flu and NAI. 660 patients were analysed (250 NAI+ and 410 NAI-). 66% of NAI+ and 40% of NAI- attended to a consultation within 24 h (P<0.001). 31% of NAI+ and 20% of NAI- had a visit at home (P=0.002). Among the patients without complication at inclusion (N=585), 3% of NAI+ received an antibiotherapy vs 13% of NAI- (P<0.001). 43% of the patients had a sick leave, shorter for the NAI+ than NAI- (respectively, 3.7+/-1.7 vs 4.2+/-1.7 days, p=0.017). NAI was taken within 3 hours (median) after prescription by the 78% of the patients who returned their diary cards. The NAI+ patients had a faster improvement of symptoms than NAI- (within 24 h, respectively: 18 vs 5%, P<0.001) and they returned faster to routine activities (within 48 h, respectively: 27 vs 11%, P<0.001).


CONCLUSIONS
This study evidenced the good use of NAI by the physicians. It confirms their therapeutic efficacy in real-life conditions and suggests their prescription allows decreasing antibiotic co-prescriptions and sick leaves duration, profits to consider in NAI benefit/risk ratio.
Gaillat
J
J
Service d'infectiologie, centre hospitalier de la région annécienne, 1, avenue de Trésum, BP 2333, 74011 Annecy cedex, France. smi.jgaillat@ch-annecy.fr
Pecking
M
M
El Sawi
A
A
Grandmottet
G
G
Schlemmer
C
C
Barbaza
M-O
MO
Carrat
F
F
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005194:Family Practice; D005602:France; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D008137:Longitudinal Studies; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D010821:Physicians, Family; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D004791:Enzyme Inhibitors; D009439:Neuraminidase