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Peer reviewedOpen accessInfluenza

Benefit of Early Oseltamivir Therapy for Adults Hospitalized With Influenza A: An Observational Study

Clinical Infectious Diseases·

Nathaniel M Lewis, Elizabeth J Harker, Lauren B Grant, Yuwei Zhu, Carlos G Grijalva, James D Chappell, Jillian P Rhoads, Adrienne Baughman, Jonathan D Casey, Paul W Blair, Ian D Jones, Cassandra A Johnson, Adam S Lauring, Manju Gaglani, Shekhar Ghamande, Cristie Columbus, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, Laurence W Busse, Jamie Felzer, Matthew E Prekker, Ithan D Peltan, Samuel M Brown, David N Hager, Michelle N Gong, Amira Mohamed, Matthew C Exline, Akram Khan, Catherine L Hough, Jennifer G Wilson, Jarrod Mosier, Nida Qadir, Steven Y Chang, Adit A Ginde, Amanda Martinez, Nicholas M Mohr, Christopher Mallow, Estelle S Harris, Nicholas J Johnson, Vasisht Srinivasan, Kevin W Gibbs, Jennie H Kwon, Ivana A Vaughn, Mayur Ramesh, Basmah Safdar, Anirudh Goyal, Lauren E DeLamielleure, Jennifer DeCuir, Diya Surie, Fatimah S Dawood, Mark W Tenforde, Timothy M Uyeki, Shikha Garg, Sascha Ellington, Wesley H Self, Manjusha Gaglani, Tresa McNeal, Shekhar Ghamande Nicole Calhoun, Kempapura Murthy, Joselyn Cravens, Judy Herrick, Amanda McKillop, Eric Hoffman, Ashley Graves, Martha Zayed, Michael Smith, Manjusha Gaglani, Cristie Columbus, Ashley Bychkowski, Symone Dunkley, Tammy Fisher, Therissa Grefsrud, Mariana Hurutado-Rodriguez, Gabriela Perez, Laurence Busse, Caitlin ten Lohuis, Jamie Felzer, Matthew Prekker, Audrey Hendrickson, Anne Frosch, Leyla Taghizadeh, Kowsar Hurreh, Mary O'Rourke, Laurynn Giles, Ivana A Vaughn, Mayur Ramesh, Lois E Lamerato, Khaled Almawri, Ishraaq Atkins, Jaleesa Clark, Jean Ashley Lava, Catherine McKeon, Zina Pinderi, Melissa Resk, Sindhuja Koneru, Rachna Jayaprakash, Shruti Tirumala, Katrina Williams, Ithan Peltan, Jenna Lumpkin, Shandi Poulson, Joslyn Bassett, Vineela Thumma, David N Hager, Harith Ali, Richard, Safa Saeed, Nicholas Mohr, Anne Zepeski, Paul Nassar, Jacob Hampton, Cathy Fairfield, Heath Gibbs, Courtney Feitsam, Ike Appleton, Michelle Ng Gong, Amira Mohamed, Luke Andrea, Matthew Exline, Sarah Karow, Gabrielle Swoope, Madison So, Manisha Pathak, David Smith, Reece Wilson, Zachery Lewald, Connor Snyder, Maryiam Khan, Brooke Lee, Amanie Rasul, Akram Khan, Adrian Hernandez-Frausto, Edvinas Pocius, Emily Tribbett, Genesis Briceno, Jose Pena, Sarah Pellicer, Raju Reddy, Gopal Allada, Jennifer Wilson, Alexandra June Gordon, Cynthia Perez, Lilian Lau, Samantha Ferguson, Vanessa Pitre, Grace Tam, Leonard Basobas, Jarrod Mosier, Karen Lutrick, Cameron Hypes, Beth Salvagio Campbell, Adit Ginde, Amanda Martinez, Aimee Steinwand, Amy Sullivan, Cori Withers, Jacob Rademacher, Rachel Obradovich, Chris Mallow, Carolina Rivas, Nicholas Johnson, Joshua Acidera, Katherine Elkort, Amol Gajendragadkar, Maile McKeown, Wesley H Self, H Keipp Talbot, Carlos Grijalva, Paul W Blair, Ian D Jones, Natasha Halasa, James D Chappell, Kelsey N Womack, Jillian Rhoads, Colleen Ratcliff, Adrienne Baughman, Jakea Johnson, Sydney Swan, Cassandra Johnson, Yuwei Zhu, Todd W Rice, Jonathan D Casey, Yuwei Zhu, Laura L Short, Lauren J Ezzell, Margaret E Whitsett, Rendie E McHenry, Samarian J Hargrave, Jennifer L Luther, Claudia Guevara Pulido, Bryan P M Peterson, Shanice L Cummings, Emma Claire Gauthier, Anna C Jackson, Neekar S Rashid, Marcia Blair, Caroline Rice, Jennie Kwon, Bijal Parikh, David McDonald, Carleigh Samuels, Lucy Vogt, Caroline O'Neil, Alyssa Valencia, Francesca Yerbic, Olivia Arter, Kim Vu, Basmah Safdar, Anirudh Goyal, Lauren DeLamielleure, Michael Kosover

DOI
10.1093/cid/ciae584
PMID
39607747
PMCID
PMC13016773
OpenAlex
W4404814594
Study type
Journal article
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

These findings support current clinical guideline recommendations to initiate antiviral therapy as soon as possible in hospitalized influenza patients. Early oseltamivir treatment was associated with meaningful reductions in severe complications and death among hospitalized adults.

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Structured evidence summary

Research question

The study examined whether initiating oseltamivir on the day of hospital admission reduces disease severity and adverse outcomes in adults hospitalized with laboratory-confirmed influenza.

Study design

This was a multicenter prospective observational study conducted through a US sentinel surveillance network at 24 hospitals between October 2022 and July 2023. The analysis used multivariable regression models to compare outcomes between patients who started oseltamivir on admission day versus those treated later or not at all, adjusting for baseline severity, demographics, site, and vaccination status.

Population and setting

The study enrolled 840 adults aged 18 years and older hospitalized with laboratory-confirmed influenza A across 24 US hospitals. Among these, 415 patients (49%) received oseltamivir on the day of admission and 425 (51%) received it later or not at all.

Main findings

Patients who received oseltamivir on admission day had lower peak pulmonary disease severity (adjusted OR 0.60, 95% CI 0.49-0.72), reduced odds of ICU admission (adjusted OR 0.24, 95% CI 0.13-0.47), lower odds of acute kidney replacement therapy or vasopressor use (adjusted OR 0.40, 95% CI 0.22-0.67), and lower in-hospital mortality (adjusted OR 0.36, 95% CI 0.18-0.72) compared to those treated later or not treated.

Public-health relevance

These findings support current clinical guideline recommendations to initiate antiviral therapy as soon as possible in hospitalized influenza patients. Early oseltamivir treatment was associated with meaningful reductions in severe complications and death among hospitalized adults.

Important limitations

As an observational study, unmeasured confounding may affect the association between treatment timing and outcomes despite statistical adjustment. The summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of study limitations, potential biases, and generalizability.

GIDS interpretation

This peer-reviewed journal article was classified under influenza surveillance and treatment topics for the United States. It provides evidence on antiviral effectiveness in hospitalized patients during the 2022-2023 influenza season but does not represent a surveillance signal or trend analysis.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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