Corticosteroids & H5N1 treatment

[sharon sanders]

Meeting of doctors who've treated bird flu cases leads to new WHO treatment advice

Published: Thursday, April 19, 2007 | 1:49 PM ET

Canadian Press: HELEN BRANSWELL


(CP) - Doctors caring for H5N1 patients should not treat them with corticosteroids, the World Health Organization said Thursday, noting the drugs don't help and sometimes harm patients trying to battle the often severe infection.
Corticosteroids should only be used on patients with persistent septic shock, a condition in which blood pressure drops to dangerous levels because of an infection in the bloodstream, the WHO advised in updated treatment guidelines, published on the agency's website.
The recommendation was one of several that emerged from a meeting last month in which physicians who have treated H5N1 patients gathered to share their experiences and observations.
The WHO-organized meeting, which took place in the Turkish town of Antalya, was an attempt to amalgamate data on as many human H5N1 cases as possible to answer questions about what works with these patients and what does not.
Pooling data on a large numbers of cases would allow patterns to come into focus that would not be apparent to doctors who treat only a patient or two.
Since H5N1 re-emerged in late 2003, nearly 300 people have been diagnosed with the infection. But those cases have spanned 12 countries. And within countries such as Indonesia, for instance, infections have cropped up over a vast geographic area. Those factors have made it difficult to amass knowledge about the best way to treat H5N1 patients - a problem the WHO is trying to rectify....

http://www.cbc.ca/cp/health/070419/x041911A.html

 

[MHSC]

Re: Corticosteroids & H5N1 treatment

WHO dispenses new advice on treating bird flu


HELEN BRANSWELL
Canadian Press

Doctors caring for H5N1 patients should not treat them with corticosteroids, the World Health Organization said Thursday, noting that the drugs do not help and sometimes harm patients trying to battle the often-severe infection.


Corticosteroids should be used only on patients with persistent septic shock, a condition in which blood pressure drops to dangerous levels because of an infection in the bloodstream, the WHO advised in updated treatment guidelines published on its website.


The recommendation was one of several that emerged from a meeting last month in which physicians who have treated H5N1 patients gathered to share their experiences and observations.


The WHO-organized meeting, which took place in the Turkish town of Antalya, was an attempt to amalgamate data on as many human H5N1 cases as possible to answer questions about what works with these patients and what does not.
Related to this article

Internet Links

• Treating H5N1(pdf)
  
• WHO avian influenza page
  

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Pooling data on a large numbers of cases would allow patterns to come into focus that would not be apparent to doctors who treat only a patient or two.


Since H5N1 re-emerged in late 2003, nearly 300 people have been diagnosed with the infection, but those cases have spanned 12 countries, and in some countries such as Indonesia, infections have cropped up over a vast geographic area.


Those factors have made it difficult to amass knowledge about the best way to treat H5N1 patients ? a problem that the WHO is trying to rectify.


A fuller summary of the Antalya meeting will be submitted for publication to a peer-reviewed journal, the WHO's release said. In the meantime, however, it offered this advice to physicians faced with H5N1 cases:


? Early treatment with the antiviral drug oseltamivir (Tamiflu) seems to reduce the risk of death in H5N1 infections. But even late treatment with the drug ? which hinders the ability of the virus to replicate ? is useful because replication can last longer with the H5N1 avian virus than in infection with human flu viruses.


? Doctors can consider doubling the Tamiflu dose, giving it for longer or combining it with another flu drug, amantadine (in countries where H5N1 viruses are not resistant to this drug) if treating patients with progressive disease or pneumonia. A decision to alter oseltamivir treatment should be made on a case-by-case basis, the WHO said, asking doctors to collect data while they do it to help answer questions about whether these types of approaches are effective.


? Doctors should not treat patients with antibiotics as a means of trying to prevent secondary bacterial infections. If an H5N1 patient develops pneumonia, ideally testing should be done to determine if the cause is bacterial and therefore requires antibiotics.



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