Impact of empirical oseltamivir discontinuation in hospitalized patients with community-acquired pneumonia after confirmed negative for influenza

Objectives: To study the effect of appropriate oseltamivir discontinuation in patients hospitalized with pneumonia, after they tested negative for influenza.

Methods: A retrospective study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Patients admitted with a diagnosis of community-acquired pneumonia and started on empirical oseltamivir were included. The duration of stay at the hospital and readmission rates were identified. Additionally, we studied factors that led healthcare providers to continue patients on oseltamivir therapy despite testing negative for influenza.

Results: A total of 210 patients were studied. The rate of empirical oseltamivir appropriate discontinuation was 31% (66 patients). No significant difference was noted between the 2 groups in the length of hospital stay (p=0.46). There was no significant difference in terms of 30-day (OR=0.67, 95% CI [0.28-1.59]), 60-day (OR=1.14, 95% CI [0.47, 2.78]), and 90-day readmission rates (OR=1.35, 95% CI [0.35-5.27]). After adjusting for other variables, admission to the intensive care unit was independently associated with appropriate discontinuation compared with patients admitted to general wards.

Conclusions: This study showed that appropriate discontinuation of empirical antiviral therapy is safe, effective, and has no impact on the length of stay and readmission rates.