J Korean Med Sci.  2014 Apr;29(4):485-493. 10.3346/jkms.2014.29.4.485.

The Association between Influenza Treatment and Hospitalization-Associated Outcomes among Korean Children with Laboratory-Confirmed Influenza

• Lim JK
• Kim TH
• Kilgore PE
• Aiello AE
• Choi BM
• Lee KC
• Yoo KH
• Song YH
• Kim YK

• KMID: 1774452
• DOI: http://doi.org/10.3346/jkms.2014.29.4.485

Abstract

There are limited data evaluating the relationship between influenza treatment and hospitalization duration. Our purpose assessed the association between different treatments and hospital stay among Korean pediatric influenza patients. Total 770 children < or = 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza at three large urban tertiary care hospitals were identified through a retrospective medical chart review. Demographic, clinical, and cost data were extracted and a multivariable linear regression model was used to assess the associations between influenza treatment types and hospital stay. Overall, there were 81% of the patients hospitalized with laboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% of the patients received oseltamivir monotherapy. The mean treatment-related charges for hospitalizations treated with antibiotics, alone or with oseltamivir, were significantly higher than those treated with oseltamivir-only (P < 0.001). Influenza patients treated with antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and 28.2%, respectively, longer duration of hospitalization compared to those treated with oseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir, were associated with longer hospitalization and significantly higher medical charges, compared to patients treated with oseltamivir alone. In Korea, there is a need for more judicious use of antibiotics, appropriate use of influenza rapid testing.

Keyword

Influenza, Human; Hospitalizations; Oseltamivir; Therapeutics; Child

MeSH Terms

Adolescent
Anti-Bacterial Agents/*therapeutic use
Antigens, Viral/analysis/immunology
Antiviral Agents/*therapeutic use
Child
Child, Preschool
Cohort Studies
Demography
Drug Therapy, Combination
Female
Hospitalization
Humans
Infant
Infant, Newborn
Influenza A virus/metabolism
Influenza B virus/metabolism
Influenza, Human/*drug therapy
Male
Oseltamivir/*therapeutic use
Republic of Korea
Retrospective Studies
Anti-Bacterial Agents
Antigens, Viral
Antiviral Agents
Oseltamivir

Figure

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  Fig. 1 Flow chart describing the ascertainment of the patient cohort with hospitalization identified during the study period of February 2004-June 2007.

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  Fig. 2 Mean length of hospital stay and duration of fever in days for 770 hospitalizations with laboratory-confirmed influenza by the treatment type, February 2004-June 2007. *P < 0.001, for comparison of the mean duration of hospital stay in antibiotics-only (5.0 days the oseltamivir-only treatment groups (3.0 days); †P < 0.001, for comparison of the mean fever duration in antibiotics-only (5.5 days) vs the oseltamivir-only treatment groups (3.8 days); ‡P = 0.012, for comparison of the mean duration of hospital stay in antibiotics-plus-oseltamivir (4.0 days the oseltamivir-only treatment groups (3.0 days).

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