Evaluating the efficiency of complex treatment of influenza A (H ₁ N ₁ ) in hospital conditions

Aim: To study the efficiency of oseltamivir depending on the time of its administration to patients with typed A (H 1 N 1 ) and non-typed influenza. Methods: The prospective evaluation of disease severity, frequency of complications and mortality in hospital patients with influenza has been executed. 720 patients with suspicion on a virus infection were surveyed. From them at 373 patients the influenza A (H 1 N 1 ) was typed by RT-PCR test. Shortness of breath was assessed by MRC scale, severity of patient state was estimated by scale APACHE II. Patients underwent x-rays, laboratory tests, spirometry and diffusion capacity of the lungs. Results: At oseltamivir administration after 48 hours from the disease beginning efficiency of therapy decreased and frequency of complications increased. The severe course of influenza on APACHE II scale was accompanied by an increase in mortality (p<0,05). The disease prognosis worsened with an increase of dyspnea after normalization of temperature (p<0,019). The negative impact of obesity and diabetes on the disease course (p<0,004) was revealed. Conclusion: The administration of oseltamivir later than 48 hours from onset of illness, severe state of patients on a scale of APACHE II, the increase of dyspnea after decrease of temperature, obesity and diabetes mellitus are risk factors for complications and adverse outcome of influenza A (H 1 N 1 ).