review board of Rush University Medical

which 16 were admitted to the intensive care unit (ICU). The most common di-agnosis at hospital admission was pneu-monia. Twenty-two (69%) of 32 patients received oseltamivir (44 % of non-ICU vs 94 % of ICU patients;). The me-Pp.002 dian duration of symptoms prior to hos-pitalization was 3 days (range, 1–7 days). The median duration from hospitalization to the administration of oseltamivir was 27.3 h (range, 3.1–222.5 h). Among pa-tients treated with oseltamivir, the median duration from the time the drug was or-dered to the time it was administered was 3.5 h (range, 1.2–17.7 h). Ten (46%) of 22 patients had a delay of 4 h from the time oseltamivir was ordered to the time of administration. Empiric treatment for pandemic (H1N1) 2009 influenza is currently recommended for all hospitalized patients with sus-pected or proven influenza [1]. Recent observations suggest a mortality benefit of antiviral treatment for hospitalized pa-tients with 2009 (H1N1) influenza and recommend that treatment be initiated as early as possible in hospitalized patients [2, 3]. We observed a significant delay (median, 27.3 h) in the initiation of os-eltamivir treatment among hospitalized patients. This may be attributable to de-lays in diagnosis or turnaround of RT-PCR results (batched and performed daily at our institution). More significant is that despite the use of an electronic medication order system, almost one-half of patients treated with oseltamivir ex-perienced a delay of 4 h before receiv-ing the drug. This may be attributable to the fact that orders for oral antivirals are not viewed with the same urgency as in-travenous antibiotics, which can be or-dered “stat. ” The early administration of antibiotics has been demonstrated to have mortality benefit and is widely viewed as an important performance in-dicator [4]. The rapid initiation of an-tiviral therapy for influenza treatment should probably be viewed with similar importance [5]. The results of our study should encourage physicians, nurses, and pharmacists to examine closely all bar-riers to timely antiviral prescribing and administration