Perceptions and Barriers to Outpatient Antiviral Therapy for COVID-19 and Influenza As Observed by Infectious Disease Specialists in North America: Results of an Emerging Infections Network (EIN) Survey, February 2024

Overview

Journal Open Forum Infect Dis

Specialty Infectious Diseases

Date 2024 Nov 29

PMID 39610406

Authors

Jordan B Singleton

Dennis Wang

Souci Louis

Dallas J Smith

Anastasia S Lambrou

Susan E Beekmann

Claire M Midgley

Philip Polgreen

Shikha Garg

Jessica N Ricaldi

Timothy M Uyeki

Scott Santibanez

Pragna Patel

Affiliations

Soon will be listed here.

Abstract

Antiviral therapy is underutilized for outpatients at increased risk for severe COVID-19 or influenza. Results from this survey offer insights into treatment barriers from the infectious disease specialist perspective. Further education is needed about the benefits of early antiviral therapy.

References

Chen H, Wang X, Yu S, Ding Y, Wang M, Wang J . Clinical Effectiveness of Intravenous Peramivir Compared With Oseltamivir in Patients With Severe Influenza A With Primary Viral Pneumonia: A Randomized Controlled Study. Open Forum Infect Dis. 2021; 8(1):ofaa562. PMC: 7793458. DOI: 10.1093/ofid/ofaa562. View

Antoon J, Sarker J, Abdelaziz A, Lien P, Williams D, Lee T . Trends in Outpatient Influenza Antiviral Use Among Children and Adolescents in the United States. Pediatrics. 2023; 152(6). PMC: 10681853. DOI: 10.1542/peds.2023-061960. View

Bhimraj A, Morgan R, Shumaker A, Lavergne V, Baden L, Cheng V . Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis. 2020; . PMC: 7197612. DOI: 10.1093/cid/ciaa478. View

Havers F, Thaker S, Clippard J, Jackson M, McLean H, Gaglani M . Use of influenza antiviral agents by ambulatory care clinicians during the 2012-2013 influenza season. Clin Infect Dis. 2014; 59(6):774-82. PMC: 4200045. DOI: 10.1093/cid/ciu422. View

Wilcock A, Kissler S, Mehrotra A, McGarry B, Sommers B, Grabowski D . Clinical Risk and Outpatient Therapy Utilization for COVID-19 in the Medicare Population. JAMA Health Forum. 2024; 5(1):e235044. PMC: 10818223. DOI: 10.1001/jamahealthforum.2023.5044. View

Angamo M, Mohammed M, Peterson G . Efficacy and safety of remdesivir in hospitalised COVID-19 patients: a systematic review and meta-analysis. Infection. 2021; 50(1):27-41. PMC: 8325414. DOI: 10.1007/s15010-021-01671-0. View

Dobson J, Whitley R, Pocock S, Monto A . Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015; 385(9979):1729-1737. DOI: 10.1016/S0140-6736(14)62449-1. View

Uyeki T, Bernstein H, Bradley J, Englund J, File T, Fry A . Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis. 2018; 68(6):e1-e47. PMC: 6653685. DOI: 10.1093/cid/ciy866. View

Hammond J, Leister-Tebbe H, Gardner A, Abreu P, Bao W, Wisemandle W . Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022; 386(15):1397-1408. PMC: 8908851. DOI: 10.1056/NEJMoa2118542. View

10.

Hayden F, Sugaya N, Hirotsu N, Lee N, de Jong M, Hurt A . Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents. N Engl J Med. 2018; 379(10):913-923. DOI: 10.1056/NEJMoa1716197. View

11.

Liu J, Lin S, Wang L, Chiu H, Lee J . Comparison of Antiviral Agents for Seasonal Influenza Outcomes in Healthy Adults and Children: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2021; 4(8):e2119151. PMC: 8363918. DOI: 10.1001/jamanetworkopen.2021.19151. View

12.

Ison M, Portsmouth S, Yoshida Y, Shishido T, Mitchener M, Tsuchiya K . Early treatment with baloxavir marboxil in high-risk adolescent and adult outpatients with uncomplicated influenza (CAPSTONE-2): a randomised, placebo-controlled, phase 3 trial. Lancet Infect Dis. 2020; 20(10):1204-1214. DOI: 10.1016/S1473-3099(20)30004-9. View

13.

Monach P, Anand S, Fillmore N, La J, Branch-Elliman W . Underuse of Antiviral Drugs to Prevent Progression to Severe COVID-19 - Veterans Health Administration, March-September 2022. MMWR Morb Mortal Wkly Rep. 2024; 73(3):57-61. PMC: 10824546. DOI: 10.15585/mmwr.mm7303a2. View

14.

Sorey W, Krantz E, Morris J, Klaassen J, Sweet A, Tverdek F . Antiviral Prescribing Among Patients at an Ambulatory Cancer Center With Laboratory-Confirmed Influenza. Open Forum Infect Dis. 2023; 10(5):ofad254. PMC: 10220506. DOI: 10.1093/ofid/ofad254. View

15.

Jayk Bernal A, Gomes da Silva M, Musungaie D, Kovalchuk E, Gonzalez A, Delos Reyes V . Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients. N Engl J Med. 2021; 386(6):509-520. PMC: 8693688. DOI: 10.1056/NEJMoa2116044. View

16.

Fowlkes A, Steffens A, Reed C, Temte J, Campbell A . Influenza Antiviral Prescribing Practices and the Influence of Rapid Testing Among Primary Care Providers in the US, 2009-2016. Open Forum Infect Dis. 2019; 6(6):ofz192. PMC: 6557305. DOI: 10.1093/ofid/ofz192. View

17.

Arbel R, Sagy Y, Hoshen M, Battat E, Lavie G, Sergienko R . Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge. N Engl J Med. 2022; 387(9):790-798. PMC: 9454652. DOI: 10.1056/NEJMoa2204919. View

18.

Yan L, Streja E, Li Y, Rajeevan N, Rowneki M, Berry K . Anti-SARS-CoV-2 Pharmacotherapies Among Nonhospitalized US Veterans, January 2022 to January 2023. JAMA Netw Open. 2023; 6(8):e2331249. PMC: 10472184. DOI: 10.1001/jamanetworkopen.2023.31249. View

19.

Malosh R, Martin E, Heikkinen T, Brooks W, Whitley R, Monto A . Efficacy and Safety of Oseltamivir in Children: Systematic Review and Individual Patient Data Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2017; 66(10):1492-1500. DOI: 10.1093/cid/cix1040. View

20.

Shim S, Chan M, Owens L, Jaffe A, Prentice B, Homaira N . Rate of use and effectiveness of oseltamivir in the treatment of influenza illness in high-risk populations: A systematic review and meta-analysis. Health Sci Rep. 2021; 4(1):e241. PMC: 7875571. DOI: 10.1002/hsr2.241. View