Influenza antiviral prescribing practices during the 2007–08 and 2008–09 influenza seasons in the setting of increased resistance to oseltamivir among circulating influenza viruses

Nila J. Dharan; Susan E. Beekmann; Anthony Fiore; Lyn Finelli; Timothy M. Uyeki; Philip M. Polgreen; Alicia M. Fry

doi:10.1016/j.antiviral.2010.08.010

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Influenza antiviral prescribing practices during the 2007–08 and 2008–09 influenza seasons in the setting of increased resistance to oseltamivir among circulating influenza viruses

Journal article

Peer reviewed

Influenza antiviral prescribing practices during the 2007–08 and 2008–09 influenza seasons in the setting of increased resistance to oseltamivir among circulating influenza viruses

Nila J. Dharan, Susan E. Beekmann, Anthony Fiore, Lyn Finelli, Timothy M. Uyeki, Philip M. Polgreen and Alicia M. Fry

Antiviral research, Vol.88(2), pp.182-186

2010

DOI: 10.1016/j.antiviral.2010.08.010

PMID: 20739002

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Abstract

In December 2008, new interim guidelines on the use of influenza antiviral agents were released in response to a high prevalence of circulating oseltamivir-resistant seasonal influenza A(H1N1) and adamantane-resistant influenza A(H3N2) viruses. Zanamivir, oseltamivir +/− an adamantane, or oseltamivir was recommended, depending on virus type, subtype, and local surveillance data. Information about antiviral prescribing practices among IDSA Emerging Infections Network (EIN) members was obtained using two web-based questionnaires; one in January 2009 regarding the prior 2007–08 influenza season and one in April 2009 (prepandemic), regarding the concurrent 2008–09 season. In the 2007–08 survey, 646 (52%) of 1249 EIN members responded and in the 2008–09 season survey, 350 (27%) of 1281 responded. In 2008–09 vs. 2007–08: 59% vs. 69% prescribed or recommended antivirals for treatment ( p < .0001); 48% vs. 80% prescribed oseltamivir alone and 39% vs. 10% prescribed zanamivir alone ( p < .0001 for both). During 2008–09 28% reported treating fewer patients compared with 2007–08; 42% felt antivirals were less effective due to resistance and 40% felt patients had less severe illness. During 2008–09, 42% of respondents reported difficulty providing zanamivir to patients vs. 5% for oseltamivir ( p < .0001). Only 11% of respondents could test for influenza A subtype. During both seasons, ∼55% used local surveillance data to make treatment decisions. A mild winter influenza season, difficulty obtaining recommended agents, and lack of access to subtype diagnosis and surveillance data may have contributed to reduced antiviral use during 2008–09.

Antiviral resistance

Antiviral use guidelines

Influenza

Physician education

Details

Title: Subtitle: Influenza antiviral prescribing practices during the 2007–08 and 2008–09 influenza seasons in the setting of increased resistance to oseltamivir among circulating influenza viruses
Creators: Nila J. Dharan - Epidemic Intelligence Service
Susan E. Beekmann - Infectious Diseases Society of America
Anthony Fiore - Centers for Disease Control and Prevention
Lyn Finelli - Centers for Disease Control and Prevention
Timothy M. Uyeki - Centers for Disease Control and Prevention
Philip M. Polgreen - Infectious Diseases Society of America
Alicia M. Fry - Centers for Disease Control and Prevention
Resource Type: Journal article
Publication Details: Antiviral research, Vol.88(2), pp.182-186
DOI: 10.1016/j.antiviral.2010.08.010
PMID: 20739002
NLM abbreviation: Antiviral Res
ISSN: 0166-3542
eISSN: 1872-9096
Publisher: Elsevier B.V
Language: English
Date published: 2010
Academic Unit: Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9984359591902771

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