Nordstrom Beth L, Sung Iyue, Suter Pia, Szneke Priscilla
Ingenix Epidemiology, Auburndale, MA 02466, USA.
Curr Med Res Opin. 2005 May;21(5):761-8. doi: 10.1185/030079905x46214.
Clinical trials suggest that the risk of pneumonia and other sequelae of influenza may be reduced in patients using oseltamivir.
This retrospective cohort study used U.S. health insurance claims data. Patients were grouped into three cohorts: (1) diagnosed with influenza-like illness (ILI) and received a dispensing of oseltamivir; (2) diagnosed with ILI but received no antiviral medication; and (3) received oseltamivir without a physician diagnosis of ILI. Baseline factors assessed included demographics, history of drug dispensings, diagnoses, and vaccinations.
Outcomes included diagnosis of pneumonia, dispensing of an antibiotic, or hospitalization within 30 days after an ILI diagnosis or oseltamivir dispensing.
The adjusted hazard ratio for ILI with oseltamivir compared to ILI without antivirals for pneumonia was 0.72 (95% CI, 0.60-0.86), for antibiotic dispensing was 0.89 (95% CI, 0.86-0.93), and for hospitalization was 0.74 (95% CI, 0.61-0.90). The cohort who received oseltamivir without an ILI diagnosis did not differ significantly in risk of any outcome from the ILI with oseltamivir cohort.
The risk of pneumonia, antibiotic dispensing, and hospitalization was reduced in patients with ILI who received oseltamivir compared to no antiviral therapy. These findings were based on health care claims only and have not been verified through medical record review.
临床试验表明,使用奥司他韦的患者患肺炎及流感其他后遗症的风险可能会降低。
这项回顾性队列研究使用了美国医疗保险理赔数据。患者被分为三组队列:(1)诊断为流感样疾病(ILI)并接受奥司他韦配药;(2)诊断为ILI但未接受抗病毒药物治疗;(3)接受奥司他韦但医生未诊断为ILI。评估的基线因素包括人口统计学、药物配药史、诊断和疫苗接种情况。
观察指标包括在ILI诊断或奥司他韦配药后30天内肺炎诊断、抗生素配药或住院情况。
与未使用抗病毒药物的ILI患者相比,使用奥司他韦的ILI患者发生肺炎的校正风险比为0.72(95%CI,0.60 - 0.86),抗生素配药的校正风险比为0.89(95%CI,0.86 - 0.93),住院的校正风险比为0.74(95%CI,0.61 - 0.90)。未诊断为ILI而接受奥司他韦治疗的队列与使用奥司他韦的ILI队列在任何观察指标的风险上均无显著差异。
与未接受抗病毒治疗相比,接受奥司他韦治疗的ILI患者发生肺炎、抗生素配药和住院的风险降低。这些发现仅基于医疗保健理赔数据,尚未通过病历审查得到验证。