Choi SH, et al. – The administration of neuraminidase inhibitors (NAIs) within 2 days after the onset of symptoms (early NAI therapy) has been shown to reduce mortality in adult patients with severe influenza. This study sought to assess supporting evidence regarding the effectiveness of early NAI therapy on mortality. Findings revealed no reduction in mortality associated with early NAI therapy in adult patients hospitalized for influenza. They identified the necessity for further clinical studies including a large number of influenza B–infected patients with virus identification using PCR methodology rather than viral culture to confirm the beneficial impact of early NAI therapy on mortality.

• The clinical data from 506 adult patients who were hospitalized for influenza was reviewed between March 2010 and March 2014, to investigate the impact of early NAI therapy on mortality.
• In this study, nearly one–third of the study patients were infected with influenza B (influenza A, influenza B, and co–infection of both in 68.8%, 28.1%, and 3.2%, respectively), and were diagnosed using the polymerase chain reaction (PCR) method (33.6%).
• Early NAI therapy was offered to less than half (233, 46.0%) of patients.
• Early NAI therapy patients were admitted to the hospital earlier, more frequently infected with influenza A, and more frequently diagnosed using rapid influenza detection tests compared to those without early NAI therapy.
• Although patients without early NAI therapy presented with more serious clinical manifestations, such as an initial symptom of dyspnea, pneumonia, and intensive care unit admission, than those with early NAI therapy, there appeared no differences regarding in–hospital mortality between the former (2.9%, 8/273) and the latter (3.4%, 8/233) (p = 0.75).