학술논문
Impact of early oseltamivir treatment on outcome in critically ill patients with 2009 pandemic influenza A
Document Type
Academic Journal
Author
Rodríguez, Alejandro; Díaz, Emili; Martín-Loeches, Ignacio; Sandiumenge, Alberto; Canadell, Laura; Díaz, Juan J.; Figueira, Juan C.; Marques, Asunción; Álvarez-Lerma, Francisco; Vallés, Jordi; Baladín, Bárbara; García-López, Fernando; Suberviola, Borja; Zaragoza, Rafael; Trefler, Sandra; Bonastre, Juan; Blanquer, José; Rello, Jordi; Cobo, Pedro; Martins, Javier; Carbayo, Cecilia; Robles-Musso, Emilio; Cárdenas, Antonio; Fierro, Javier; Fernández, Dolores Ocaña; Sierra, Rafael; Jesús Huertos, M; Carlos Pozo, Juan; Guerrero, R.; Márquez, Enrique; Rodríguez-Carvajal, Manuel; Jareño, Antonio; Pomares, José; Ballesteros, José Luis; Fernández, Yolanda; Lobato, Francisco; Prieto, José F.; Albofedo-Sánchez, José; Martínez, Pilar; Díaz Castellanos, Miguel Angel; Sevilla, Guillermo; Garnacho-Montero, José; Hinojosa, Rafael; Fernández, Esteban; Loza, Ana; León, Cristóbal; Arenzana, Angel; Ocaña, Dolores; Navarrete, Inés; Zaheri Beryanaki, Medhi; Sánchez, Ignacio; Avellanas, Manuel Luis; Lander, Arantxa; Ramírez de Arellano, S. Garrido; Marquina Lacueva, M. I.; Luque, Pilar; González, Ignacio; Montón, Jose M; Dorado Regil, Paloma; Iglesias, Lisardo; Pascual González, Carmen; Quiroga; García-Rodríguez, Águeda; Socias, Lorenzo; Ibánez, Pedro; Borges-Sa, Marcío; Socias, Antonia; Del Castillo, A.; Jordà Marcos, Ricard; Bonell, José M.; Amestarán, Ignacio; Ruiz-Santana, Sergio; Díaz, Juan José; Sisón; Hernández, David; Trujillo, Ana; Regalado, Luis; Lorente, Leonardo; Martín, Mar; Martínez, Sergio; Cáceres, J. J.; Suberviola, Borja; Ugarte, P.; García-López, Fernando; Álvaro Alonso, Angel; Pasilla, Antonio; Gómez Grande, M Luisa; Albaya, Antonio; Canabal, Alfonso; Marina, Luis; Simón, Almudena; María Añón, José; López Messa, Juan B.; López Pueyo, M Jesús; Ferreras, Zulema; Macias, Santiago; Ángel Berezo, José; Varela, Jesús Blanco; Ojeda, A. Andaluz; Terrero, Antonio Álvarez; Tena Ezpeleta, Fabiola; Paez, Zulema; García, Álvaro; Catalán, Rosa M; Ferrer, Miquel; Torres, Antoni; Barbadillo, Sandra; Cabré, Lluís; Rovira, Assumpta; Álvarez-Lerma, Francisco; Vázquez, Antonia; Nolla, Joan; Fernández, Francisco; Cervelló, Joaquim Ramón; Mañéz, Rafael; Ballús, J.; Granada, Rosa M; Vallés, Jordi; Ortíz, Marta; Guía, C.; Arméstar, Fernando; Páez, Joaquim; Almirall, Jordi; Balanzo, Xavier; Rello, Jordi; Arnau, Elena; Llopart, Lluis; Palomar, Mercedes; Catalán, Iñaki; Sirvent, Josep M; Ferri, Cristina; de Arbina, Nerea López; Badía, Mariona; Valverdú-Vidal, Montserrat; Barcenilla, Fernando; Magret, Mònica; Esteban, M. F.; Luna, José; Nava, Juan M; de Molina, J. González; Josic, Zoran; Gurri, Francisco; Rodríguez, Alejandro; Lisboa, Thiago; de Mendoza, Diego; Trefler, Sandra; María Díaz, Rosa; Mesalles, Eduard; José, Juliá-Narváez; Fernández-Zapata, Alberto; Recio, Teresa; Arrascaeta, Abilio; García-Ramos, M José; Gallego, Elena; Bueno, Fernándo; Díaz, Mercedes; Cordero, M Lourdes; Pastor, José A.; Álvarez–Rocha, Luis; Vila, Dolores; Lamas, Ana Díaz; Pérez, Javier Blanco; Ortiz Piquer, M.; Merayo, Eleuterio; López-Ciudad, Victor Jose; Cortez, Juan; Vilaboy, Eva; Saborido, Eva Maria; González, Raul José; Freita, Santiago; López, Ana María; Canabal, Julio; Ferres, Enrique; Monzón, José Luis; Goñi, Félix; Del Nogal Sáez, Frutos; Blasco Navalpotro, M.; García-Torrejón, M Carmen; Pérez–Calvo, César; López, Diego; Arnaiz, Luis; Sánchez-Alonso, S.; Velayos, Carlos; del Río, Francisco; González, Miguel Ángel; Martín, María Cruz; Molina, José M; Montejo, Juan Carlos; Catalán, Mercedes; Albert, Patricia; de Pablo, Ana; Guerrero, José Eugenio; Peyrat, Jaime Benitez; Cerdá, Enrique; Alvarez, Manuel; Pey, Carlos; Rodríguez, Montse; Palencia, Eduardo; Caballero, Rafael; Vaquero, Concepción; Mariscal, Francisco; García, S.; Carrasco, Nieves; Prieto, Isidro; Liétor, A.; Ramos, R.; Galván, Beatríz; Figueira, Juan C.; Soriano, M. Cruz; Galdós, P.; Balandin Moreno, Bárbara; del Cabo, Fernández; Hermosa, Cecilia; Gordo, Federico; Algora, Alejandro; Paredes, Amparo; Cambronero, J. A.; Gómez-Rosado, Sonia; Prado López, Luis Miguel; Martínez, Sofía; Abad, F. Felices; Martínez, Mariano; Butí, Sergio Manuel; Gil Rueda, Bernardo; García, Francisco; Macaya, Laura; Maraví-Poma, Enrique; Jimenez Urra, I.; Macaya Redin, L.; Tellería, A.; Insansti, Josu; González, Nagore; Marco, Pilar; Vidaur, Loreto; Santamaría, B.; Vergara, Juan Carlos; Iruretagoyena Amiano, Jose Ramon; Manzano, Alberto; Arenal, Carlos Castillo; Olaechea, Pedro María; Blanquer, José; Reig Valero, Roberto; Belenger, A.; Altaba, Susana; Álvarez-Sánchez, Bernabé; Alberto Picos, Santiago; Sánchez-Miralles, Ángel; Bonastre, Juan; Palamo, M.; Cebrian, Javier; Cuñat, José; Romero, Belén; Zaragoza, Rafael; Paricio, Virgilio; Marques, Asunción; Sánchez-Morcillo, S.; Tormo, S.; Latour, J.; Ángel García, M.; Ribas, Antoli
Source
Journal of Antimicrobial Chemotherapy. May 01, 2011 66(5):1140-1149
Subject
Language
English
ISSN
0305-7453
Abstract
OBJECTIVES: The impact of oseltamivir on mortality in critically ill patients with 2009 pandemic influenza A (2009 H1N1) is not clear. The main objective of this study was to investigate the relationship between the timing of antiviral administration and intensive care unit (ICU) outcomes. METHODS: Prospective, observational study of a cohort of ICU patients with confirmed 2009 H1N1 infection. Clinical data, treatment and outcome were compared between patients receiving early treatment (ET) with oseltamivir, initiated within 2 days, and patients administered late treatment (LT), initiated after this timepoint. Multivariate analysis and propensity score were used to determine the effect of oseltamivir on ICU mortality. RESULTS: Six hundred and fifty-seven patients were enrolled. Four hundred and four (61.5%) patients required mechanical ventilation (MV; mortality 32.6%). Among them, 385 received effective antiviral therapy and were included in the study group. All patients received oseltamivir for a median duration of 10 days (interquartile range 8–14 days). Seventy-nine (20.5%) ET patients were compared with 306 LT patients. The two groups were comparable in terms of main clinical variables. ICU length of stay (22.7 ± 16.7 versus 18.4 ± 14.2 days; P = 0.03), hospital length of stay (34.0 ± 20.3 versus 27.2 ± 18.2 days; P = 0.001) and MV days (17.4 ± 15.2 versus 14.0 ± 12.4; P = 0.04) were higher in the LT group. ICU mortality was also higher in LT (34.3%) than in ET (21.5%; OR = 1.9; 95% CI 1.06–3.41). A multivariate model identified ET (OR = 0.44; 95% CI 0.21–0.87) as an independent variable associated with reduced ICU mortality. These results were confirmed by propensity score analysis (OR = 0.44; 95% CI 0.22–0.90; P < 0.001). CONCLUSIONS: Our findings suggest that early oseltamivir administration was associated with favourable outcomes among critically ill ventilated patients with 2009 H1N1 virus infection.