These patients will receive early oseltamivir plus current, standard empiric antibacterial therapy.

These patients will be treated with the current, standard care, including currently recommended antibiotics or antiviral therapy based on national recommendations from the IDSA/ATS guidelines for management of hospitalized patients with CAP and ACIP antiviral use guidelines for hospitalized patients with confirmed of suspect influenza, per clinician discretion. In addition these patients with have a NP swab collected for influenza PCR testing and clinical information will be extracted from the medical record.

These patients will receive early oseltamivir plus current, standard empiric antibacterial therapy.
oseltamivir: These patients will receive early (within 8-12 hours of admission, no later than 24 hours after admission) oseltamivir plus current, standard empiric antibacterial therapy based on national recommendations from the IDSA/ATS guidelines for management of hospitalized patients with CAP (2). Anti-influenza therapy will be given using oseltamivir at a dose of 75 mg twice daily. The oseltamivir dose will be adjusted in patients with renal insufficiency according to the package insert. Duration of antiviral therapy will be for a minimum of 5 days for patients with evidence of early clinical improvement and prolonged depending on clinical stability

Oseltamirvir

Standard of Care

Total

Sex: Female, Male

Region of Enrollment

Nursing home Resident

Number of subject that showed lack of clinical improvement within 7 days. Criteria for clinical improvement include no fever; white blood cell count decreases, or increases in the case of leukopenia, to more than 10% from the prior day; the evaluation of signs and symptoms of CAP to define when the patient is subjectively better, and the patient is able to tolerate food by mouth.

Number of Participants With Clinical Failure (Failure to Reach Clinical Stability)

Number of subjects that were transfered to an intensive care unit (ICU) after 24 hours of hospitalization. A patient transferred to ICU within 24 hours of admission was considered as a direct admission to ICU and not meeting criteria for clinical failure.

Number of Participants to Transfer to ICU After 24 h

Participants that were re-hospitalized within 30 days after enrollment.

Number of Participants That Required Re-hospitalization

Number of subjects who died within 30 days of enrollment

Number of Participants That Had Short-term Mortality

Time to clinical improvement. The criteria for clinical improvement were followed during the first week from the day of admission and defined as follows: a) improvement of signs and symptoms of LRTI reported by patient b) afebrile for at least 8 hours, c) decrease in white blood cell count to more than 10% from the prior day, and d) able to tolerate oral feeding. A patient was considered clinically improved on the day that these four criteria were all met.

Days to Reach Clinical Stability

Duration of hospitalization calculated as the day of discharge minus the day of admission.

Length of Hospital Stay

Number of subjects who died while hospitalized

Number of Participants With Hospital Mortality.

Overall Study

Dr. Paula Peyrani

Influenza

Pneumonia

These patients will receive early (within 8-12 hours of admission, no later than 24 hours after admission) oseltamivir plus current, standard empiric antibacterial therapy based on national recommendations from the IDSA/ATS guidelines for management of hospitalized patients with CAP (2). Anti-influenza therapy will be given using oseltamivir at a dose of 75 mg twice daily. The oseltamivir dose will be adjusted in patients with renal insufficiency according to the package insert. Duration of antiviral therapy will be for a minimum of 5 days for patients with evidence of early clinical improvement and prolonged depending on clinical stability

oseltamivir

Jewish Hospital

Norton Hospital

University of Louisville Hospital

Rex Robley VA Medical Center

Baptist Hospital East

Rapid Empiric Treatment With Oseltamivir Study (RETOS)

Title: Effectiveness of Empiric Antiviral Treatment for Hospitalized Community Acquired Pneumonia During the Influenza Season (U18)

Julio Ramirez

Professor

University of Louisville

Centers for Disease Control and Prevention

Patients will be randomized into this arm will be provided with 0.10% PVP-I (0.01% available iodine). Patients will be instructed to dilute 2.5mL of the betadine (unmarked bottles) into a 240mL bottle of saline and rinse once per day.

Patients will be randomized into this arm will be provided with a placebo PVP-I solution. Patients will be instructed to dilute 2.5mL of the placebo PVP-I (unmarked bottles) into a 240mL bottle of saline and rinse once per day.

Chronic Rhinosinusitis (Diagnosis)

For the PVP-I group, the final concentration of available iodine in the solution will be 0.01%, (from diluting 10% PVP-I solution), as previously demonstrated to be below ciliotoxic levels of 1.25% and greater than 0.01% which is the lower limit of active potency.

Povidone-Iodine

The placebo will be 2.5mL of saline with brown food coloring.

Placebos

Povidone-Iodine Rinses as an Adjuvant Therapy Post-Operatively

Povidone-Iodine Rinses as an Adjuvant Therapy Post-Operatively: A Double-Blind Randomized Controlled Trial

This score is based on the endoscopic assessment of polyps, edema, and discharge and are each given score 0-2. A higher score indicates a worse outcome.

Assess whether there is positive growth of bacteria or fungi.

This is a standard of care form that includes 22 questions about symptoms and social/emotional consequences of your nasal disorder. You will be asked to rate your problems as they have been over the past two weeks. Patients give a score out of 110 where a higher score indicates a worse outcome.

Test to assess nasal mucociliary clearance. Place a small amount of saccharin one cm behind the anterior aspect of the inferior turbinate. Normal mucociliary would result in saccharin being swept backwards to the nasopharynx, allowing the subject to taste the sweet saccharin.

Many CRS patients have a disturbed/ reduced sense of smell. Sniffn' Sticks is a type of test to assess your sense of smell by using various scented pens. The threshold and identification tests will be performed. A score will be given out of 32 with a lower score indicating a worse outcome/sense of smell.

false/bactericida

Rapid Empiric Treatment With Oseltamivir Study (RETOS)

Povidone-Iodine Rinses as an Adjuvant Therapy Post-Operatively

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