Evaluation of Diagnostic and Therapeutic Approaches for Suspected Influenza A(H1N1)pdm09 Infection, 2009–2010

摘要

To assess adherence to real-time changes in guidelines for in. uenza diagnosis and use of oseltamivir during the 2009 in. uenza A(H1N1) pandemic, we reviewed medical records of patients with confi rmed or suspected in. uenza-like illness (ILI) and those with no viral testing in a large Los Angeles (California, USA) hospital. Of 882 tested patients, 178 had results positive for in. uenza; 136 of the remaining patients received oseltamivir despite negative or no results. Oseltamivir use was consistent with national recommendations in >90%. Of inpatients, children were less likely than adults to have ILI at testing and to receive oseltamivir if ILI was found. Of outpatients, children were more likely to have positive test results; 20% tested did not have ILI or other in. uenza signs and symptoms. Twenty-fi ve of 96 test-positive patients and 13 of 19 with lower respiratory tract disease were, inappropriately, not treated. Variations between practice and national recommendations could inform clinical education in future in. uenza seasons