Assessment of efficacy of oseltamivir-azithromycin combination therapy in prevention of influenza-a (H1N1) infection complications and rapidity of symptom relief.

Ishaqui, Azfar Athar; Khan, Amer Hayat; Sulaiman, Syed Azhar Syed; Alsultan, Muhammad Taher; Khan, Irfanullah; Naqvi, Atta Abbas

Objectives: This study aimed to assess the efficacy of Oseltamivir-Azithromycin combination therapy for prevention of Influenza-A(H1)pdm09 infection associated complications and early relief of influenza symptoms.Methods: In a retrospective observational cohort study, Influenza-A(H1)pdm09 infection hospitalized patients were identified and divided into two groups based on the initial therapy. Group-AV patients were initiated on Oseltamivir without any antibiotic in treatment regimen while Group-AV+AZ patients were initiated on Oseltamivir and Azithromycin combination therapy for at least 3-5 days. Patients were evaluated for different clinical outcomes.Results: A total of 227 and 102 patients were identified for Group-AV and Group-AV+AZ respectively. The identified patients of both groups were mostly unvaccinated. Multivariate regression analysis showed that incidences of secondary bacterial infections were significantly less frequent (23.4% vs 10.4%; P-value=0.019) in Group-AV+AZ patients. Group-AV+AZ patients were associated with shorter length of hospitalization (6.58 vs 5.09 days; P-value=<0.0001) and less frequent incidences of respiratory support (38.3% vs 17.6%; P-value=0.016). Overall influenza symptom severity score was statistically significant less for Group-AV+AZ patients on Day-5 (10.68±2.09; P-value=0.001) of hospitalization.Conclusion: Oseltamivir-Azithromycin combination therapy was found to be more efficacious as compared to Oseltamivir alone in rapid recovery and prevention of Influenza associated complications especially in high risk patients.