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CIDRAP- Tamiflu cuts risk of death in older adults, study suggests

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  • CIDRAP- Tamiflu cuts risk of death in older adults, study suggests

    https://www.cidrap.umn.edu/influenza...study-suggests

    Tamiflu cuts risk of death in older adults, study suggests



    Stephanie Soucheray, MA


    28 minutes ago.

    Influenza, General A Canadian study published today in Open Forum Infectious Diseases shows that adults 65 years and older had a significant reduction in mortality risk if given the antiviral oseltamivir (Tamiflu) during influenza hospitalizations, regardless of vaccination status.

    The study did show, however, that the risk reduction was significant only for infections from influenza A and not influenza B, which is typically less common.

    18% lower risk of death within 30 days


    The study involved 8,135 influenza patients, including 6,009 (74%) who were treated with oseltamivir during their hospitalization. The patients were seen across five Canadian provinces during flu seasons from 2012 to 2019.

    The participants were divided into three groups: Those who did not receive Tamiflu, those who received the drugs within 48 hours of hospital admission, and those who received the medicine after 48 hours of hospital admission. Thirty-day mortality was compared for all three groups.

    All patients were 65 years or older, had confirmed influenza infections, and were hospitalized, with 395 patients hospitalized for more than 30 days.

    Oseltamivir recipients had a 18% lower risk of 30-day mortality (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.69 to 0.98). The overall mortality rate was 8.32 per 1,000 person-days, with 53.9% of the deaths occurring within the first week of hospitalization, the authors said. The overall mortality ratio within 30 days of hospitalization was 8% (653 deaths among 8,135 patients).

    Only 45% got Tamiflu on day of admission


    Antivirals are supposed to be started as close to symptom onset as possible, but the study showed that even treatment received more than 48 hours after hospitalization was still tied to a statistically significant lower mortality (HR, 0.66; 95% CI, 0.49 to 0.90).

    The improved mortality rates were not significant among patients with influenza B, however. (HR, 1.12; 95% CI, 0.81 to 1.56).

    The study authors said that 44.9% of those prescribed Tamiflu started it on the day of hospitalization, 35.8% started it 1 day post-hospitalization, and 11.3% initiated treatment 2 days post-hospitalization.

    But despite its status as the standard of care, only 74% of patients in the study received Tamiflu.

    Our findings confirm the effectiveness of oseltamivir in a typically underrepresented group in clinical trials.

    "Our findings confirm the effectiveness of oseltamivir in a typically underrepresented group in clinical trials, challenging hesitancy towards late antiviral treatment and emphasizing prompt intervention," the authors wrote. "Healthcare providers should prioritize early oseltamivir administration to reduce the mortality risk and potentially redefine protocols for this high-risk group."
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