1268. Influenza antiviral prescribing practices among outpatients with acute respiratory illnesses during influenza season—United States, 2010-11 to 2013-14
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
  • FINAL_POSTER_CES_20OCT16.pdf (476.6 kB)
  • Background: Influenza infections account for approximately 20% of outpatient acute respiratory illness (ARI) visits; however, most are not diagnosed as influenza. Early influenza antiviral treatment is recommended for all outpatients with confirmed or suspected influenza who are at high risk for influenza-associated complications, including those <2 years of age or with chronic medical conditions. For all other outpatients, treatment can be considered based on clinical judgment. However, outpatient antiviral prescribing practices are poorly understood. We describe antiviral prescribing practices among outpatients with ARI.

    Methods: We analyzed U.S. commercial insurance plans’ billing data for persons <65 years of age from Marketscan databases, during four influenza seasons (2010-11 through 2013-14), the dates of which were defined by national surveillance data. We used ICD9 diagnosis codes to identify patients with outpatient visits for ARI who received influenza antiviral prescriptions within two weeks of the ARI visit and who had previous diagnoses of chronic medical conditions.

    Results: Among 40,889,124 ARI visits, 1,022,783 (2.5%) had an associated antiviral prescription; among 1,464,243 visits with an influenza visit (ICD codes 487, 488), 44% had an antiviral prescription. Those <2 years had significantly lower proportions of ARI (1.1%) or influenza visits (35%) with an antiviral prescription compared with those 18-49 years (3.1% of ARI visits and 46.6% for influenza visits; p<0.01 for both; Figures A and B). Among persons with high risk conditions, 2.2% of 15,469,131 ARI visits and 43% of 509,088 influenza visits had an antiviral prescription, compared with 2.8% of 2,519,993 ARI visits and 45% of 1,043,036 influenza visits among persons with no high risk condition (p<0.01, for both). The proportion of influenza visits with antiviral prescriptions ranged from 39% in 2011-12 to 45% in 2013-14.

    Conclusion: Antiviral prescriptions were infrequent for those <2 years or with high risk medical conditions, in both outpatient ARI and influenza visits. Prescription patterns were not consistent with current guidance recommendations.  However, we lacked data on clinical presentation and other factors which may influence antiviral prescribing.

    Courtney Strickland, BS1, Alicia M. Fry, MD, MPH1, Jerome Tokars, MD, MPH2, Jufu Chen, PhD3 and Fiona Havers, MD, MHS1, (1)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (2)CDC, Atlanta, GA, (3)Centers for Disease Control and Prevention, Atlanta, GA


    C. Strickland, None

    A. M. Fry, None

    J. Tokars, None

    J. Chen, None

    F. Havers, None

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