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Abstract
Purpose
There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. Methods: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. Results: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was 3.6±2.8 year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period (4.18±2.10 vs 4.79±1.49 days, P=.17) and total fever duration (5.32±2.07 vs 6.41±3.25 days, P=.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. Conclusion: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.
References
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Fig. 1.
Monthly Distribution of Children with Influenza B Infections from January, 2012 to July, 2012.
Table 1.
Comparison of Demographic Characteristics and Clinical Manifestations between Study Groups
| Characteristics | Total (n=72) | Total patients (n=72) | ||
|---|---|---|---|---|
| Non-oseltamivir∗(n=34) | Oseltamivir†(n=38) | P-value | ||
| Gender (male/female) | 37/35 | 18/16 | 19/19 | 0.80 |
| Age (years) | 3.6±2.78 | 3.03±2.34 | 4.11±3.06 | 0.10 |
| Daycare center (yes/no) | 45/13 | 23/4 | 22/9 | 0.31 |
| Past medical history‡ (yes/no) | 16/56 | 4/30 | 12/26 | 0.05 |
| Influenza vaccination (yes/no) | 24/38 | 11/17 | 13/21 | 1.00 |
| Cough (yes/no) | 67/5 | 31/3 | 36/2 | 0.66 |
| Sore throat (yes/no) | 24/45 | 11/21 | 13/24 | 0.95 |
| Rhinitis (yes/no) | 49/21 | 22/11 | 27/10 | 0.57 |
| GI Sxʃ (yes/no) | 28/44 | 11/23 | 17/21 | 0.28 |
| Admission (yes/no)∥ | 67/5 | 34/0 | 33/5 | 0.06 |
| Admission period (days) | 4.47±1.85 | 4.79±1.49 | 4.18±2.10 | 0.17 |
| Diagnostic method (Rapid antigen test/PCR) | 51/21 | 19/15 | 32/6 | 0.01 |
| Peak BT¶ (℃) | 39.5±0.69 | 39.58±0.78 | 39.40±0.56 | 0.29 |
| Antibiotics (yes/no) | 50/22 | 28/6 | 22/16 | 0.04 |
| Time lag days∥ | 3.5±2.57 | 3.79±3.25 | 3.24±1.76 | 0.38 |
| Fever duration after admission (days) | 2.6±1.51 | 2.71±1.38 | 2.37±1.59 | 0.38 |
| Total fever duration (days) | 5.87±2.86 | 6.41±3.25 | 5.32±2.07 | 0.09 |
| C-reactive protein (mg/dL) | 0.67 (0.35–2.82)∗∗ | 0.85 (0.55–3.41)∗∗ | 0.46 (0.03–1.94)∗∗ | 0.04 |
Table 2.
Comparison between Timing of Oseltamivir Administration
| Variables | Non-oseltamivir∗(n=36) | Within 48 hrs†(n=10) | After 48 hrs‡(n=26) | P-value |
|---|---|---|---|---|
| Gender (male/female) | 19/17 | 5/5 | 13/13 | 0.97 |
| Age (years) | 3.06±2.31 | 3.70±2.58 | 4.31±3.32 | 0.22 |
| Influenza vaccination | 11/18 | 2/5 | 11/15 | 0.42 |
| Cough (yes/no) | 29/3 | 7/1 | 23/0 | 0.28 |
| Sore throat (yes/no) | 9/23 | 3/5 | 9/14 | 0.67 |
| Rhinitis (yes/no) | 21/11 | 5/3 | 18/5 | 0.54 |
| GI Sxʃ (yes/no) | 11/21 | 3/5 | 12/11 | 0.41 |
| Admission (yes/no) | 35/1 | 10/0 | 22/4 | 0.10 |
| Admission period (days) | 4.61±1.68 | 5.10±1.37 | 4.04±2.18 | 0.25 |
| Peak BT¶ (℃) | 39.64±0.78 | 39.00±0.61 | 39.58±0.52 | 0.09 |
| Antibiotics (yes/no) | 30/6 | 2/8 | 18/8 | 0.00 |
| Time lag days∥ | 3.75±3.19 | 2.00±1.33 | 3.73±1.66 | 0.14 |
| Fever duration after admission (days) | 2.81±1.39 | 2.14±1.95 | 2.44±1.54 | 0.51 |
| Total fever duration (days) | 6.52±3.44 | 3.88±1.81 | 5.68±1.77 | 0.06 |
| C-reactive protein (mg/dL) | 0.85 (0.55–3.41)∗∗ | 0.30 (0.00–1.13)∗∗ | 1.25 (0.31–2.53)∗∗ | 0.28 |
Values are presented as mean±standard deviation or number.∗Children with influenza B not treated with oseltamivir.
† Children with influenza B given their first dose of oseltamivir within 48 hours from the onset of fever.
Table 3.
Demographic Characteristics and Clinical Manifestations in Children Under 3 Years of Age with Influenza B Infections (n=44)
| Characteristic | Non-oseltamivir group∗(n=24) | Oseltamivir group†(n=20) | P-value |
|---|---|---|---|
| Gender (male/female) | 12/12 | 10/10 | 1.00 |
| Age (years) | 1.83±0.82 | 1.80±0.95 | 0.80 |
| Daycare Center (yes/no) | 17/4 | 8/6 | 0.15 |
| Past medical history‡ (yes/no) | 1/23 | 4/16 | 0.16 |
| Influenza vaccination (yes/no) | 8/11 | 8/10 | 1.00 |
| Admission (yes/no) | 24/0 | 17/3 | 0.09 |
| Admission period (days) | 4.88±1.45 | 4.25±2.38 | 0.57 |
| Peak BT∫ (℃) | 39.62±0.87 | 39.40±0.38 | 0.66 |
| Antibiotics (yes/no) | 18/6 | 9/11 | 0.06 |
| Time lag days∥ | 4.25±3.29 | 3.10±1.94 | 0.25 |
| Fever duration after admission (days) | 2.95±1.23 | 2.75±1.57 | 0.65 |
| Total fever duration (days) | 6.58±3.28 | 5.74±2.16 | 0.82 |
| C-reactive protein (mg/dL) | 0.69 (0.52–3.16)∗∗ | 0.35 (0.00–1.78)∗∗ | 0.01 |
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