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- Title
Impact of neuraminidase inhibitor treatment on outcomes of public health importance during the 2009-2010 influenza A(H1N1) pandemic: a systematic review and meta-analysis in hospitalized patients.
- Authors
Muthuri SG; Myles PR; Venkatesan S; Leonardi-Bee J; Nguyen-Van-Tam JS; Muthuri, Stella G; Myles, Puja R; Venkatesan, Sudhir; Leonardi-Bee, Jo; Nguyen-Van-Tam, Jonathan S
- Abstract
<bold>Background: </bold>The impact of neuraminidase inhibitor (NAI) treatment on clinical outcomes of public health importance during the 2009-2010 pandemic has not been firmly established.<bold>Methods: </bold>We conducted a systematic review and meta-analysis, searching 11 databases (2009 through April 2012) for relevant studies. We used standard methods conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random effects models.<bold>Results: </bold>Regarding mortality we observed a nonsignificant reduction associated with NAI treatment (at any time) versus none (OR, 0.72 [95% CI, .51-1.01]). However we observed significant reductions for early treatment (≤48 hours after symptom onset) versus late (OR, 0.38 [95% CI, .27-.53]) and for early treatment versus none (OR, 0.35 [95% CI, .18-.71]). NAI treatment (at any time) versus none was associated with an elevated risk of severe outcome (OR, 1.76 [95% CI, 1.22-2.54]), but early versus late treatment reduced the likelihood (OR, 0.41 [95% CI, .30-.56]).<bold>Conclusions: </bold>During the 2009-2010 influenza A(H1N1) pandemic, early initiation of NAI treatment reduced the likelihood of severe outcomes compared with late or no treatment.<bold>Prospero Registration: </bold>CRD42011001273.
- Publication
Journal of Infectious Diseases, 2013, Vol 207, Issue 4, p553
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jis726