July 22, 2014
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Few outpatients receive antiviral prescriptions for influenza

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Only 7.5% of patients presenting to ambulatory care for acute respiratory illness received an antiviral prescription, CDC researchers have found. Among the patients with confirmed influenza, only 15% received an antiviral prescription.

“Influenza vaccination is the primary strategy to prevent influenza,” the researchers wrote in Clinical Infectious Diseases. “However, antiviral treatment plays an important role in decreasing influenza-related morbidity and mortality. Our results suggest that during 2012-2013, antiviral medications were underprescribed and antibiotics may have been inappropriately prescribed to a large proportion of outpatients with influenza.”

Using data from five sites in the US Influenza Vaccine Effectiveness Network Study, the researchers determined the number of patients aged at least 6 months who presented for outpatient care with acute respiratory illness. They evaluated how many patients were prescribed antiviral medications and how many had confirmed influenza by PCR. They also analyzed antibiotic prescriptions at four sites with that data.

There were 6,766 patients with acute respiratory illness and 509 (7.5%) received an antiviral prescription. Among the patients, 2,366 had confirmed influenza and only 355 (15%) had received an antiviral prescription. The cohort also included 1,021 patients at high risk for influenza-associated complications due to age or chronic medical condition. Among those, 195 (19%) received an antiviral prescription.

In a subset of 1,825 patients who had confirmed influenza and data on antibiotic prescriptions, 540 (30%) were prescribed either amoxicillin-clavulanate, amoxicillin or azithromycin. Only 297 of the 1,825 patients (16%) were prescribed antiviral medications.

“Few ambulatory care providers appeared to follow current antiviral guidance recommending antiviral treatment for persons at high risk for influenza-associated complications,” the researchers wrote. “Additional efforts are needed to understand the barriers to the use of antiviral treatment in ambulatory care settings and to better communicate the benefits of prompt antiviral therapy.”

Disclosure: Some researchers report relationships with BioCryst Pharmaceuticals, Inviragen, Medimmune, Merck, Novartis, Pfizer, Roche and Sanofi.