Impact of Zanamivir on Antibiotic Use for Respiratory Events Following Acute Influenza in Adolescents and Adults

Abstract

UPPER AND lower respiratory tract events leading to antibiotic prescriptions are common complications of influenza virus infection.¹ Influenza leads to alteration of nasal patency, eustachian tube dysfunction, middle ear pressure abnormalities, and accumulation of fluids in the middle ear and/or paranasal sinuses, events that promote secondary bacterial infections. The causal role of influenza virus infection in development of otitis media or acute sinusitis has been demonstrated in experimental infection of animals and humans.^2-4 In addition, lower respiratory complications, particularly bronchitis and pneumonia, are well-recognized consequences of influenza illness. This association has been confirmed again in recent reports involving elderly persons^5-7 and younger adults.⁸ However, the type and frequency of respiratory complications and associated antibiotic use following proven influenza illness in adults living in the community has not been prospectively assessed in large populations. Furthermore, it is unknown whether treatment of influenza A illness with the M2 inhibitors amantadine and rimantadine reduces complications.⁹