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Abstract
Background: Oseltamivir (Tamiflu) is a neuraminidase inhibitor widely prescribed in viral pneumonia, particularly influenza. However, evidence regarding its impact on in-hospital length of stay (LOS) in real-world tertiary care settings in Pakistan remains limited.
Objective: To compare the total in-hospital length of stay between viral pneumonia patients treated with and without oseltamivir at a private tertiary care hospital in Lahore, and to evaluate associated clinical outcomes including clinical improvement, ICU admission, oxygen therapy requirements, complications, and in-hospital mortality.
Methods: A retrospective observational study was conducted using data collected from 57 patients admitted with viral pneumonia. Patients were classified into two groups: those who received oseltamivir (n=33) and those who did not (n=20). Key outcomes including total LOS, clinical improvement at 72 hours, ICU admission rates, complications, in-hospital mortality, and 30-day readmission were analyzed and compared between the two groups.
Results: The mean LOS was significantly longer in the oseltamivir group (7.2 ± 2.8 days) compared to the non-oseltamivir group (4.4 ± 1.0 days). Despite this, clinical improvement within 72 hours was higher in the oseltamivir group (81.8% vs 60.0%). ICU admission was more frequent in the oseltamivir group (27.3% vs 5.0%), reflecting greater baseline disease severity. In-hospital mortality was zero in both groups. Seventy-five percent of oseltamivir-treated patients received the drug more than 72 hours after symptom onset.
Conclusion: The longer LOS observed in the oseltamivir group likely reflects greater initial disease severity rather than a detrimental drug effect. Delayed initiation of oseltamivir was common, which may have impacted outcomes. Early initiation of antiviral therapy in appropriately selected patients remains important. These findings highlight the need for prospective controlled studies to better delineate the true impact of oseltamivir on hospital stay in Pakistani tertiary care settings