Written by Caitlin Nicholson
Delayed initiation of antiviral therapy in adults hospitalized with influenza-associated pneumonia was associated with higher 30-day mortality and severe outcomes.
Considering antiviral treatment? Don’t delay!
This large retrospective cohort study evaluated the association between timing of antiviral therapy initiation and 30-day mortality in 26,233 adults hospitalized with influenza-associated pneumonia across seven influenza seasons using FluSurv-NET data. Patients starting antivirals on day 1 (aOR 1.14, 95%CI 1.01–1.27) or days 2-5 (aOR 1.40, 95%CI 1.17–1.66) after admission had significantly higher odds of death compared to those treated on admission day (day 0). Delayed antiviral initiation was consistently associated with increased mortality and other severe outcomes.
How will this change my practice?
This study underscores the critical role of antiviral treatment in the emergency department. A recent observational study, detailed on JournalFeed, shows similar findings. These results align with current IDSA guidelines, which recommend antiviral therapy for any influenza-positive patient hospitalized with acute respiratory illness. I will continue administering antivirals to influenza-positive patients requiring admission, regardless of symptom duration.
Source
Timing of Influenza Antiviral Therapy and Risk of Death in Adults Hospitalized With Influenza-Associated Pneumonia, Influenza Hospitalization Surveillance Network (FluSurv-NET), 2012-2019. Clin Infect Dis. 2025 Feb 24;80(2):461-468. doi: 10.1093/cid/ciae427. PMID: 39172994
