title: Evaluation of diagnostic and therapeutic approaches for suspected influenza A(H1N1)pdm09 infection, 2009-2010.
abstract: To assess adherence to real-time changes in guidelines for influenza diagnosis and use of oseltamivir during the 2009 influenza A(H1N1) pandemic, we reviewed medical records of patients with confirmed or suspected influenza-like illness (ILI) and those with no viral testing in a large Los Angeles (California, USA) hospital. Of 882 tested patients, 178 had results positive for influenza; 136 of the remaining patients received oseltamivir despite negative or no results. Oseltamivir use was consistent with national recommendations in >90%. Of inpatients, children were less likely than adults to have ILI at testing and to receive oseltamivir if ILI was found. Of outpatients, children were more likely to have positive test results; 20% tested did not have ILI or other influenza signs and symptoms. Twenty-five of 96 test-positive patients and 13 of 19 with lower respiratory tract disease were, inappropriately, not treated. Variations between practice and national recommendations could inform clinical education in future influenza seasons.
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA.
authors.forename: Vini
authors.initials: V
authors.lastname: Vijayan
authors.forename: Jennie
authors.initials: J
authors.lastname: Jing
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Zangwill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D007297:Inpatients; D015141:Los Angeles / Q000453:epidemiology; D008875:Middle Aged; D053139:Oseltamivir / Q000008:administration & dosage / Q000627:therapeutic use*; D010045:Outpatients; D058873:Pandemics; D010349:Patient Compliance; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir