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Expert Rev Clin Pharmacol. 2016 Oct 31. [Epub ahead of print]
The pharmacological management of severe influenza infection - 'existing and emerging therapies'.
Mc Mahon A1, Martin-Loeches I1,2.
Author information
Abstract
INTRODUCTION:
Over the last century several influenza outbreaks have traversed the globe, most recently the influenza A(H1N1) 2009 pandemic. On each occasion, a highly contagious, virulent pathogen has emerged, leading to significant morbidity and mortality amongst those affected. Areas covered: Early antiviral therapy and supportive care is the mainstay of treatment. Treatment should be started as soon as possible and not delayed for the results of diagnostic testing. Whilst oseltamivir is still the first choice, in case of treatment failure, oseltamivir resistance should be considered, particularly in immunosuppressed patients. Here we review the antivirals currently used for management of influenza and explore a number of investigational agents that may emerge as effective antivirals including parenteral agents, combination antiviral therapy and novel agents in order to adequately target influenza virulence. Expert Commentary: New tools for rapid diagnosis and susceptible strains will help if a patient is not improving because of a resistant strain or an inadequate immune response. Further randomized control trials will be conducted to investigate the use of new antivirals and co-adjuvant therapies that will help to elucidate the process of immune modulation, particularly in immunocompetent patients.
KEYWORDS:
H1N1; influenza; influenza virus-bacteria co-infection; oseltamivir; peramivir; steroids; zanamivir
PMID: 27797595 DOI: 10.1080/17512433.2017.1255550
[PubMed - as supplied by publisher]
The pharmacological management of severe influenza infection - 'existing and emerging therapies'.
Mc Mahon A1, Martin-Loeches I1,2.
Author information
Abstract
INTRODUCTION:
Over the last century several influenza outbreaks have traversed the globe, most recently the influenza A(H1N1) 2009 pandemic. On each occasion, a highly contagious, virulent pathogen has emerged, leading to significant morbidity and mortality amongst those affected. Areas covered: Early antiviral therapy and supportive care is the mainstay of treatment. Treatment should be started as soon as possible and not delayed for the results of diagnostic testing. Whilst oseltamivir is still the first choice, in case of treatment failure, oseltamivir resistance should be considered, particularly in immunosuppressed patients. Here we review the antivirals currently used for management of influenza and explore a number of investigational agents that may emerge as effective antivirals including parenteral agents, combination antiviral therapy and novel agents in order to adequately target influenza virulence. Expert Commentary: New tools for rapid diagnosis and susceptible strains will help if a patient is not improving because of a resistant strain or an inadequate immune response. Further randomized control trials will be conducted to investigate the use of new antivirals and co-adjuvant therapies that will help to elucidate the process of immune modulation, particularly in immunocompetent patients.
KEYWORDS:
H1N1; influenza; influenza virus-bacteria co-infection; oseltamivir; peramivir; steroids; zanamivir
PMID: 27797595 DOI: 10.1080/17512433.2017.1255550
[PubMed - as supplied by publisher]