Assessment of efficacy of oseltamivir-azithromycin combination therapy in prevention of influenza-a (H1N1) infection complications and rapidity of symptom relief

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Expert Rev Respir Med. 2020 Feb 13. doi: 10.1080/17476348.2020.1730180. [Epub ahead of print] Assessment of efficacy of oseltamivir-azithromycin combination therapy in prevention of influenza-a (H1N1) infection complications and rapidity of symptom relief.

Ishaqui AA^1,2,3, Khan AH¹, Sulaiman SAS¹, Alsultan MT^2,3, Khan I¹, Naqvi AA^4,5.
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Abstract

Objectives: This study aimed to assess the efficacy of Oseltamivir-Azithromycin combination therapy for prevention of Influenza-A(H1)pdm09 infection associated complications and early relief of influenza symptoms.Methods: In a retrospective observational cohort study, Influenza-A(H1)pdm09 infection hospitalized patients were identified and divided into two groups based on the initial therapy. Group-AV patients were initiated on Oseltamivir without any antibiotic in treatment regimen while Group-AV+AZ patients were initiated on Oseltamivir and Azithromycin combination therapy for at least 3-5 days. Patients were evaluated for different clinical outcomes.Results: A total of 227 and 102 patients were identified for Group-AV and Group-AV+AZ respectively. The identified patients of both groups were mostly unvaccinated. Multivariate regression analysis showed that incidences of secondary bacterial infections were significantly less frequent (23.4% vs 10.4%; P-value=0.019) in Group-AV+AZ patients. Group-AV+AZ patients were associated with shorter length of hospitalization (6.58 vs 5.09 days; P-value=<0.0001) and less frequent incidences of respiratory support (38.3% vs 17.6%; P-value=0.016). Overall influenza symptom severity score was statistically significant less for Group-AV+AZ patients on Day-5 (10.68?2.09; P-value=0.001) of hospitalization.Conclusion: Oseltamivir-Azithromycin combination therapy was found to be more efficacious as compared to Oseltamivir alone in rapid recovery and prevention of Influenza associated complications especially in high risk patients.


KEYWORDS:

Antiviral Combination; Azithromycin; Influenza A (H1)pdm09; Influenza complications; Oseltamivir; Secondary bacterial infection; Symptom Relief

PMID: 32053044 DOI: 10.1080/17476348.2020.1730180