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_|ABSTRACT: Comparison of the Clinical Effectiveness of Oseltamivir and Zanamivir against Influenza Virus Infection in Children|_

Giuseppe

Emeritus
Comparison of the Clinical Effectiveness of Oseltamivir and Zanamivir against Influenza Virus Infection in Children

Norio Sugaya,1 - Daisuke Tamura,1,a - Masahiko Yamazaki,3 - Masataka Ichikawa,4 - Chiharu Kawakami,2 - Yoshihiro Kawaoka,5,7,8 and
Keiko Mitamura6

1)Department of Pediatrics, Keiyu Hospital, and 2)Yokohama City Institute of Health, Yokohama, 3)Zama Children's Clinic, Zama, 4)Ichikawa Children's Clinic, Isehara, 5)Division of Virology, Department of Microbiology and Immunology and International Center for Infectious Diseases, Institute of Medical Science, University of Tokyo, and 6)Department of Pediatrics, Eiju General Hospital, Tokyo, and 7)Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan; and 8)Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison

Background.
We compared the clinical effectiveness of oseltamivir and zanamivir in children with influenza A (H1N1) virus, influenza A (H3N2) virus, and influenza B virus infections.

Methods.
Total febrile period and the duration of fever after the start of treatment were compared between an oseltamivir-treated group (mean age, 8.9 years; range, 4.0-15.9 years) and a zanamivir-treated group (mean age, 10.0 years; range, 4.0-15.7 years) in the pediatric outpatient clinics of our hospitals.
Oseltamivir was used to treat 91 children with influenza A (H3N2) infection and 24 children with influenza A (H1N1) infection.
Zanamivir was used to treat 35 children with influenza A (H3N2) infection and 12 children with influenza A (H1N1) infection.
Oseltamivir was also used to treat 128 children with influenza B virus infection, and zanamivir was used to treat 59 with influenza B virus infection.

Results.
There was no statistically significant difference in total febrile period or duration of fever after the start of treatment between the oseltamivir-treated group and the zanamivir-treated group of children with influenza A (H3N2) infection (mean duration of febrile period, 2.40 days vs. 2.39 days; mean duration of fever after the start of treatment, 1.35 days vs. 1.40 days), influenza A (H1N1) (mean duration of febrile period, 2.60 days vs. 2.46 days; mean duration of fever after the start of treatment, 1.79 days vs, 1.54 days), or influenza B (mean duration of febrile period, 2.95 days vs. 2.84 days; mean duration of fever after the start of treatment, 1.86 days vs. 1.67 days).
Oseltamivir was more effective against influenza A (H3N2) than against influenza A (H1N1) or influenza B.

Conclusions.
Oseltamivir and zanamivir were equally effective in reducing the febrile period of children with influenza A (H1N1), influenza A (H3N2), and influenza B virus infection.

Received 26 December 2007; accepted 13 March 2008; electronically published 26 June 2008.
a)Present affiliation: Division of Virology, Department of Microbiology and Immunology and International Center for Infectious Diseases, Institute of Medical Science, University of Tokyo, Japan.
(See the editorial commentary by Monto on pages XXX-XX)
Reprints or correspondence: Dr. Norio Sugaya, Keiyu Hospital, Dept. of Pediatrics, 3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-0012 Kanagawa, Japan (sugaya-n@za2.so-net.ne.jp).
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http://www.journals.uchicago.edu/doi/abs/10.1086/589748
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