Early versus late oseltamivir treatment in severely ill patients with 2009 pandemic influenza A (H1N1): speed is life

[tetano]

J Antimicrob Chemother. 2011 Mar 15. [Epub ahead of print]
Early versus late oseltamivir treatment in severely ill patients with 2009 pandemic influenza A (H1N1): speed is life.

Kumar A.

Section of Critical Care Medicine and Infectious Diseases, Health Sciences Centre and St Boniface Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract

The need for early antimicrobial therapy is well established for life-threatening bacterial and fungal infections including meningitis and sepsis/septic shock. However, a link between the outcome of serious viral infections and delays in antiviral therapy is not as well recognized. Recently, with the occurrence of the influenza A/H1N1 pandemic of 2009, a large body of data regarding this issue has become available. Studies analysing data from this pandemic have consistently shown that delays in initiation of antiviral therapy following symptom onset are significantly associated with disease severity and death. Optimal survival and minimal disease severity appear to result when antivirals are started as soon as possible after symptom onset.

PMID: 21406435 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/21406435

[Laidback Al]

Re: Early versus late oseltamivir treatment in severely ill patients with 2009 pandemic influenza A (H1N1): speed is life

Optimal survival and minimal disease severity appear to result when antivirals are started as soon as possible after symptom onset.

It is generally accepted that individuals exhibiting H5N1 influenza symptoms have the best chance of survival if treated with oseltamivir within 48 hours of symptom onset.This was recognized as early as 2005 in an article on oseltamivir resistance in two H5N1 patients in Vietnam.

The efficacy of oseltamivir is unlikely to be optimal when treatment is instituted late in the course of illness, as has been the case in most patients with influenza A (H5N1) virus infection reported to date.

http://www.nejm.org/doi/full/10.1056...2#t=articleTop