Office for Infectious Control, National Center for Child Health and Development, Tokyo, Japan.
Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
Pediatr Pulmonol. 2018 Jun;53(6):802-808. doi: 10.1002/ppul.24021. Epub 2018 Apr 19.
Neuraminidase inhibitors are recommended for children hospitalized with influenza-related respiratory infections, and oseltamivir is the first choice of treatment in most situations. However, little is known regarding the recent trend in using neuraminidase inhibitors and their difference in health economy. The aim of this study was to reveal recent trends in neuraminidase inhibitor use and compare hospitalization costs across different treatment regimens.
We retrospectively obtained the hospital discharge records of inpatients under 18 years of age with a diagnosis of influenza-related respiratory infections using a national inpatient database in Japan. We excluded patients with chronic medical conditions from the analyses. Multivariable mixed effects regression models were used to investigate the recent treatment trends and healthcare costs.
We identified 27 771 inpatients with influenza-related respiratory infections. The proportions of neuraminidase inhibitor use increased from 62.6% in 2010 to 71.8% in2014 (P < 0.001). Correspondingly, the proportions of peramivir use showed an upward trend, ranging from 31.4% to 57.4% (P < 0.001). In contrast, proportions of oseltamivir and zanamivir use decreased from 26.1% to 12.1% and from 4.9% to 1.5%, respectively (P < 0.001). Laninamivir use did not change over the period. Total hospitalization costs were higher in the peramivir group than in the oseltamivir group (adjusted difference, $84.3; 95%CI, $70.7-$98.4).
We observed an increasing trend in peramivir use and decreasing trends in use of oseltamivir and zanamivir. Treatment with peramivir required higher hospitalization costs.
神经氨酸酶抑制剂被推荐用于因流感相关呼吸道感染住院的儿童，且在大多数情况下奥司他韦是治疗的首选药物。然而，对于神经氨酸酶抑制剂的近期使用趋势及其在健康经济学方面的差异知之甚少。本研究旨在揭示神经氨酸酶抑制剂的近期使用趋势，并比较不同治疗方案的住院费用。
我们使用日本国家住院数据库，回顾性地获取了年龄在 18 岁以下、被诊断为流感相关呼吸道感染的住院患者的住院记录。我们从分析中排除了患有慢性疾病的患者。使用多变量混合效应回归模型来研究近期治疗趋势和医疗保健费用。
我们共确定了 27771 例流感相关呼吸道感染的住院患者。神经氨酸酶抑制剂的使用比例从 2010 年的 62.6%增加到 2014 年的 71.8%（P<0.001）。相应地，喷昔洛韦的使用比例呈上升趋势，从 31.4%到 57.4%（P<0.001）。相比之下，奥司他韦和扎那米韦的使用比例从 26.1%降至 12.1%，从 4.9%降至 1.5%（P<0.001）。拉尼那韦的使用在整个研究期间没有变化。与奥司他韦组相比，喷昔洛韦组的总住院费用更高（调整差异，$84.3；95%CI，$70.7-$98.4）。
我们观察到喷昔洛韦的使用呈上升趋势，奥司他韦和扎那米韦的使用呈下降趋势。使用喷昔洛韦治疗需要更高的住院费用。
