Low rate of oseltamivir prescription among adults and children with confirmed influenza illness in France during the 2018-19 influenza season.

Abstract

BACKGROUND\nOseltamivir shows effectiveness in reducing influenza-related symptoms, morbidity and mortality. Its prescription remains suboptimal.\n\n\nOBJECTIVES\nWe aim to describe oseltamivir prescription in confirmed cases of influenza and to identify associated factors.\n\n\nMETHODS\nA prospective monocentric observational study was conducted between 1 December 2018 and 30 April 2019. All patients with a virologically confirmed influenza diagnosis were included. Factors associated with oseltamivir prescription were studied.\n\n\nRESULTS\nInfluenza was confirmed in 755 patients (483 children and 272 adults), of which 188 (25.1%) were hospitalized and 86 (11.4%) had signs of severity. Oseltamivir was prescribed for 452 patients (59.9%), more frequently in children than in adults [329/483 (68.1%) versus 123/272 (45.2%), P\u2009<\u20090.001]. Factors associated with oseltamivir prescription were evaluated in 729 patients (246 adults and 483 children). Patients with at least one risk factor for severe influenza received oseltamivir less frequently (50%, 137/274) than those without risk factors (70%, 315/452) (P\u2009<\u20090.001). Pregnant women received oseltamivir in 81% of cases (17/21). Severe influenza cases were treated with oseltamivir in only 45.3% (39/86). The median duration of symptoms was 24\u2009h (IQR 12-48) in treated patients versus 72\u2009h (IQR 48-120) in untreated patients (P\u2009<\u20090.01).\n\n\nCONCLUSIONS\nOseltamivir should be administered as early as possible, preferably within 24-48\u2009h after illness onset, for the best benefits. It is, however, very important to promote the use of neuraminidase inhibitor ( NAI ) treatment beyond 48\u2009h in some specific patient populations.