Les inhibiteurs de la neuraminidase dans la grippe en médecine générale : qui prescrit, quand et avec quels résultats ?

Autor: C. Schlemmer, G. Grandmottet, Fabrice Carrat, A. El Sawi, M.-O. Barbaza, J. Gaillat, M. Pecking
Rok vydání: 2005
Předmět:
Zdroj: Médecine et Maladies Infectieuses. 35:435-442
ISSN: 0399-077X
DOI: 10.1016/j.medmal.2005.10.001
Popis: Objective. – To describe in real-life conditions the flu therapeutic management, motivations to prescribe or not NAI (General Practitioners' (GPs) characteristics, decisional factors) and treated patients' course. Design. – A prospective, longitudinal, pharmacoepidemiological study involved 305 GPs in France during 2002–2003 winter epidemic peak. All patients ≥ 1 year old, with a clinical diagnostic of flu were included. Results. – One hundred and eighty-five GPs (150 NAI prescribing and 30 non-prescribing physicians) have included at least 1 patient. Prescribing physicians were the best informed on flu and NAI. 660 patients were analysed (250 NAI+ and 410 NAI–). 66% of NAI+ and 40% of NAI– attended to a consultation within 24 h (P < 0.001). 31% of NAI+ and 20% of NAI– had a visit at home (P = 0.002). Among the patients without complication at inclusion (N = 585), 3% of NAI+ received an antibiotherapy vs 13% of NAI– (P < 0.001). 43% of the patients had a sick leave, shorter for the NAI+ than NAI– (respectively, 3.7 ± 1.7 vs 4.2 ± 1.7 days, p = 0.017). NAI was taken within 3 hours (median) after prescription by the 78% of the patients who returned their diary cards. The NAI+ patients had a faster improvement of symptoms than NAI– (within 24 h, respectively: 18 vs 5%, P < 0.001) and they returned faster to routine activities (within 48 h, respectively: 27 vs 11%, P < 0.001). Conclusions. – This study evidenced the good use of NAI by the physicians. It confirms their therapeutic efficacy in real-life conditions and suggests their prescription allows decreasing antibiotic co-prescriptions and sick leaves duration, profits to consider in NAI benefit/risk ratio.
Databáze: OpenAIRE