Description of antiviral treatment among adults hospitalized with influenza before and during the 2009 pandemic: United States, 2005-2009.
BACKGROUND
The 2009 influenza pandemic led to guidelines emphasizing antiviral treatment for all persons hospitalized with influenza, including pregnant women. We compared antiviral use among adults hospitalized with influenza before and during the pandemic.


METHODS
The Emerging Infections Program conducts active population-based surveillance for persons hospitalized with community-acquired, laboratory-confirmed influenza in 10 states. We analyzed data collected via medical record review of patients aged ≥18 years admitted during prepandemic (1 October 2005 through 14 April 2009) and pandemic (15 April 2009 through 31 December 2009) time frames.


RESULTS
Of 5943 adults hospitalized with influenza in prepandemic seasons, 3235 (54%) received antiviral treatment, compared with 4055 (82%) of 4966 during the pandemic. Forty-one (22%) of 187 pregnant women received antiviral treatment in prepandemic seasons, compared with 369 (86%) of 430 during the pandemic. Pregnancy was a negative predictor of antiviral treatment before the pandemic (adjusted odds ratio [aOR], 0.24; 95% confidence interval [CI], .16-.35) but was independently associated with treatment during the pandemic (aOR, 1.97; 95% CI, 1.32-2.96). Antiviral treatment among adults hospitalized >2 days after illness onset increased from 43% before the pandemic to 79% during the pandemic (P < .001).


CONCLUSIONS
Antiviral treatment of hospitalized adults increased during the pandemic, especially among pregnant women. This suggests that many clinicians followed published guidance to treat hospitalized adults with antiviral agents. However, compliance with antiviral recommendations could be improved.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Saumil
S
Doshi
Laurie
L
Kamimoto
Lyn
L
Finelli
Alejandro
A
Perez
Arthur
A
Reingold
Ken
K
Gershman
Kimberly
K
Yousey-Hindes
Kathryn
K
Arnold
Patricia
P
Ryan
Ruth
R
Lynfield
Craig
C
Morin
Joan
J
Baumbach
Emily B
EB
Hancock
Nancy M
NM
Bennett
Shelley
S
Zansky
Ann
A
Thomas
William
W
Schaffner
Alicia M
AM
Fry
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000547:Amantadine / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D012299:Rimantadine / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D053243:Zanamivir / Q000627:therapeutic use
D000998:Antiviral Agents; D012299:Rimantadine; D053139:Oseltamivir; D000547:Amantadine; D053243:Zanamivir