• Stella G Muthuri, Sudhir Venkatesan, Puja R Myles, Jo Leonardi-Bee, Wei Shen Lim, Abdullah Al Mamun, Ashish P Anovadiya, Wildo N Araújo, Eduardo Azziz-Baumgartner, Clarisa Báez, Carlos Bantar, Mazen M Barhoush, Matteo Bassetti, Bojana Beovic, Roland Bingisser, Isabelle Bonmarin, Victor H Borja-Aburto, Bin Cao, Jordi Carratala, María R Cuezzo, Justin T Denholm, Samuel R Dominguez, Pericles A D Duarte, Gal Dubnov-Raz, Marcela Echavarria, Sergio Fanella, James Fraser, Zhancheng Gao, Patrick Gérardin, Maddalena Giannella, Sophie Gubbels, Jethro Herberg, Higuera Iglesias Anjarath L AL Epidemiology Research Unit, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Mexico City, Mexico., Peter H Hoeger, Matthias Hoffmann, Xiaoyun Hu, Quazi T Islam, Mirela F Jiménez, Amr Kandeel, Gerben Keijzers, Hossein Khalili, Gulam Khandaker, Marian Knight, Gabriela Kusznierz, Ilija Kuzman, Arthur M C Kwan, Lahlou Amine Idriss I Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, University Mohammed V-Souissi, R, Eduard Langenegger, Kamran B Lankarani, Yee-Sin Leo, Rita Linko, Pei Liu, Faris Madanat, Toshie Manabe, Elga Mayo-Montero, Allison McGeer, Ziad A Memish, Gokhan Metan, Dragan Mikić, Kristin G I Mohn, Ahmadreza Moradi, Pagbajabyn Nymadawa, Bulent Ozbay, Mehpare Ozkan, Dhruv Parekh, Mical Paul, Wolfgang Poeppl, Fernando P Polack, Barbara A Rath, Alejandro H Rodríguez, Marilda M Siqueira, Joanna Skręt-Magierło, Ewa Talarek, Julian W Tang, Antoni Torres, Selda H Törün, Dat Tran, Timothy M Uyeki, Annelies van Zwol, Wendy Vaudry, Daiva Velyvyte, Tjasa Vidmar, Paul Zarogoulidis, PRIDE Consortium Investigators, and Jonathan S Nguyen-Van-Tam.
• Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
• Influenza Other Respi Viruses. 2016 May 1; 10 (3): 192-204.

BackgroundThe impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection.MethodsA worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids.ResultsOf 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)].ConclusionsEarly NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

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