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A total of 348 patients were included: 234 during the pandemic period and 114 during the first post-pandemic influenza season. Patients during the post-pandemic period were older and more likely to have chronic obstructive pulmonary disease, chronic kidney disease and cancer than the others. Septic shock, altered mental status and respiratory failure on arrival at hospital were significantly more common during the post-pandemic period. Time from illness onset to receipt of antiviral therapy was also longer during this period. Early antiviral therapy was less frequently administered to patients during the post-pandemic period (22.9% versus 10.9%; p?0.009). In addition, ATM inhibitor length of stay was longer, and need for mechanical ventilation and intensive-care unit admission were significantly higher during the post-pandemic period. In-hospital mortality (5.1% versus 21.2%; p?Parvulin Physicians should consider influenza A (H1N1) 2009 when selecting microbiological testing and treatment in patients with pneumonia in the upcoming influenza season. Pandemic influenza A (H1N1) virus emerged in Mexico during the spring of 2009 and spread rapidly worldwide [1], resulting in the first influenza pandemic of the twenty-first century. The epidemiological features, clinical spectrum of illness and risk factors for severe disease of pandemic influenza were broadly consistent across all countries [2�C4]. Cases of infection occurred mostly in children and young adults. The majority of patients had self-limited mild-to-moderate uncomplicated disease. However, some patients developed severe illness and some died; most of these were adults between the ages of 20 and 50?years, with or without underlying medical conditions [2�C6]. Importantly, BEZ235 solubility dmso most patients requiring intensive-care unit (ICU) admission had respiratory failure due mainly to primary influenza pneumonia [5,7,8]. Bacterial co-infection, although relatively infrequent, has also been associated with poor prognosis [5,9]. These patterns differed significantly from those seen during epidemics of seasonal influenza. In addition, in experimentally infected animals, the level of pulmonary replication of the influenza A (H1N1) 2009 virus was higher than that of seasonal influenza viruses [10]. In August 2010, the WHO declared the pandemic (H1N1) 2009 to be over.