Antivirals underprescribed for high-risk patients, researchers say
By Robert Preidt
THURSDAY, July 17, 2014 (HealthDay News) -- Antiviral drugs aren't prescribed often enough for patients at high risk for flu complications, while too many of them receive unneeded antibiotics, a new study says.
The findings show that doctors require more training about the proper use of antiviral and antibiotic drugs in treating flu patients, the researchers said. Unnecessary use of antibiotics contributes to the development of antibiotic resistance.
"Our results suggest that during 2012-13, antiviral medications were underprescribed and antibiotics may have been inappropriately prescribed to a large proportion of outpatients with influenza," wrote Dr. Fiona Havers and colleagues from the U.S. Centers for Disease Control Prevention and several other institutions.
The researchers analyzed data from about 6,800 patients with flu symptoms seen at five outpatient care centers in Michigan, Pennsylvania, Texas, Wisconsin and Washington state during the 2012-13 flu season. The team focused on prescription records for two antiviral drugs for flu -- oseltamivir (Tamiflu) and zanamivir (Relenza) -- and three widely used antibiotics (amoxicillin-clavulanate, amoxicillin, and azithromycin).
Antiviral drugs were prescribed to only 19 percent of patients who were at high risk for flu complications and saw a primary care provider within two days of their flu symptoms emerging. And only 16 percent of patients with laboratory-confirmed flu got oseltamivir or zanamivir.
However, 30 percent of these patients were prescribed antibiotics, which are typically ineffective against flu unless it has progressed to a bacterial infection, according to the study. The study was published July 17 in the journal Clinical Infectious Diseases.
"Continuing education on appropriate antibiotic and antiviral use is essential to improve health care quality," the researchers said.
The author of an accompanying editorial, Dr. Michael Ison, said benefits associated with antiviral therapy for influenza include fewer lower respiratory infections and hospitalizations and reduced antibiotic use and stroke risk.
The study "demonstrates that we are clearly failing our patients by not providing antiviral therapy to patients with influenza consistent with current guidelines while exposing many of the patients to antibiotics from which they likely derive little benefit," wrote Ison, associate professor of infectious diseases and organ transplantation at the Northwestern University Feinberg School of Medicine in Chicago.
The elderly, very young children and people with certain chronic diseases are considered at high risk of flu complications, including pneumonia and bronchitis. Pregnant women also fall into the high-risk category, according to the CDC.
The U.S. Centers for Disease Control and Prevention has more about flu antiviral drugs.
SOURCE: Clinical Infectious Diseases, news release, July 17, 2014
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