Contemporary Influenza Diagnostics: Renewed Focus on Testing Patients

Editorials19 September 2017Contemporary Influenza Diagnostics: Renewed Focus on Testing PatientsMichael G. Ison, MD, MSMichael G. Ison, MD, MSFrom Northwestern University Feinberg School of Medicine, Chicago, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2235 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Antiviral therapy for influenza has been studied in many settings and has consistently reduced illness, mortality, and complications when started early (1–4). Despite this clear benefit, suboptimal use of antiviral and antibacterial therapy for patients with confirmed influenza exists in both ambulatory and hospitalized settings (5, 6). In recent studies of ambulatory adults, antiviral and antibacterial therapies were prescribed to 15% and 30%, respectively, of outpatients with influenza (7). In recent studies of hospitalized adults, prescription of antiviral agents for influenza was low in the prepandemic period (51% to 57%, with early therapy prescribed in 47% to 55%) and increased ...References1. Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015;385:1729-37. [PMID: 25640810] doi:10.1016/S0140-6736(14)62449-1 CrossrefMedlineGoogle Scholar2. Hurt AC, Kelly H. Debate regarding oseltamivir use for seasonal and pandemic influenza. Emerg Infect Dis. 2016;22:949-55. [PMID: 27191818] doi:10.3201/eid2206.151037 CrossrefMedlineGoogle Scholar3. Muthuri SG, Myles PR, Venkatesan S, Leonardi-Bee J, Nguyen-Van-Tam JS. Impact of neuraminidase inhibitor treatment on outcomes of public health importance during the 2009-2010 influenza A(H1N1) pandemic: a systematic review and meta-analysis in hospitalized patients. J Infect Dis. 2013;207:553-63. [PMID: 23204175] doi:10.1093/infdis/jis726 CrossrefMedlineGoogle Scholar4. Venkatesan S, Myles PR, Leonardi-Bee J, Muthuri SG, AlMasri M, Andrews N, et al. Impact of outpatient neuraminidase inhibitor treatment in patients infected with influenza A(H1N1)pdm09 at high risk of hospitalization: an individual participant data metaanalysis. Clin Infect Dis. 2017;64:1328-1334. [PMID: 28199524] doi:10.1093/cid/cix127 CrossrefMedlineGoogle Scholar5. Ison MG. Editorial commentary: failing our patients by suboptimally treating influenza infections [Editorial]. Clin Infect Dis. 2014;59:783-6. [PMID: 25034418] doi:10.1093/cid/ciu425 CrossrefMedlineGoogle Scholar6. Lee N, Ison MG. Editorial commentary. “Late” treatment with neuraminidase inhibitors for severely ill patients with influenza: better late than never? [Editorial]. Clin Infect Dis. 2012;55:1205-8. [PMID: 22843780] doi:10.1093/cid/cis642 CrossrefMedlineGoogle Scholar7. Havers F, Thaker S, Clippard JR, Jackson M, McLean HQ, Gaglani M, et al. Use of influenza antiviral agents by ambulatory care clinicians during the 2012-2013 influenza season. Clin Infect Dis. 2014;59:774-82. [PMID: 25034419] doi:10.1093/cid/ciu422 CrossrefMedlineGoogle Scholar8. Appiah GD, Chaves SS, Kirley PD, Miller L, Meek J, Anderson E, et al. Increased antiviral treatment among hospitalized children and adults with laboratory-confirmed influenza, 2010-2015. Clin Infect Dis. 2017;64:364-367. [PMID: 28013261] doi:10.1093/cid/ciw745 CrossrefMedlineGoogle Scholar9. Dugas A, Rothman R. Clinical utility of rapid molecular-based influenza testing. Open Forum Infect Dis. 2015;2:102. [PMID: 27437407] doi:10.1093/ofid/ofv131.22 CrossrefMedlineGoogle Scholar10. Merckx J, Wali R, Schiller I, Caya C, Gore GC, Chartrand C, et al. Diagnostic accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction. A systematic review and meta-analysis. Ann Intern Med. 2017;167:394-409. doi:10.7326/M17-0848 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Northwestern University Feinberg School of Medicine, Chicago, Illinois.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2235.Corresponding Author: Michael G. Ison, MD, MS, Professor, Divisions of Infectious Diseases & Organ Transplantation, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue Suite 900, Chicago, IL 60611; e-mail, [email protected]edu.This article was published at Annals.org on 5 September 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase Polymerase Chain Reaction Joanna Merckx , Rehab Wali , Ian Schiller , Chelsea Caya , Genevieve C. Gore , Caroline Chartrand , Nandini Dendukuri , and Jesse Papenburg Metrics Cited byNeuraminidase inhibitors as a strategy for influenza treatment: pros, cons and future perspectivesUnderstanding user requirements to improve adoption of influenza diagnostics in clinical care within Metro ManilaImproving Delivery of Early Treatment to Influenza-Infected Patients 19 September 2017Volume 167, Issue 6Page: 438-439KeywordsAntibacterial therapyAntiviral therapyDiagnostic techniquesDisclosureImmunoassaysPatientsReverse transcriptase polymerase chain reactionSpecificitySystematic reviewsTreatment guidelines ePublished: 5 September 2017 Issue Published: 19 September 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...