tetano
Editor, Senior Moderator
J Microbiol Immunol Infect. 2015 Sep 9. pii: S1684-1182(15)00839-7. doi: 10.1016/j.jmii.2015.08.016. [Epub ahead of print]
[h=1]Effects of corticosteroid and neuraminidase inhibitors on survival in patients with respiratory distress induced by influenza virus.[/h] Huang SF[SUP]1[/SUP], Fung CP[SUP]2[/SUP], Perng DW[SUP]3[/SUP], Wang FD[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND/PURPOSE:[/h] Neuraminidase inhibitors (NAIs) including oseltamivir and peramivir are used for influenza treatment. A systemic corticosteroid is usually administrated for acute respiratory distress syndrome. The aim of this study was to investigate the effect of a systemic corticosteroid and its interaction with NAIs in patients with influenza infection and respiratory distress.
[h=4]METHODS:[/h] A retrospective survey of hospitalized patients infected with influenza from January 2012 to May 2014 was conducted in a medical center in Taiwan.
[h=4]RESULTS:[/h] Eighty-six patients were hospitalized during the study period. Forty-eight patients had respiratory distress and 39 of them (81.3%, 39/48) were supported by a mechanical ventilator. All patients with respiratory distress received oseltamivir; 60.4% (29/48) and 31.3% (15/48) of them received a corticosteroid and salvage intravenous peramivir, respectively. All-cause mortality was 29.1% (14/48), 20% (3/15), and 31% (9/29) in patients with respiratory distress, patients who received salvage peramivir, and patients who received a systemic corticosteroid, respectively. Salvage peramivir seemed to improve prognosis in patients with H1pdm09 or type B virus infection and respiratory distress (p = 0.05). Early initiating corticosteroid had a worse prognosis than initiation after 72 hours of NAI treatment (p = 0.024). In particular, a systemic corticosteroid seemed to lead to a shorter survival time in patients with chronic lung disease (p = 0.05).
[h=4]CONCLUSION:[/h] Salvage peramivir provided a better prognosis than monotherapy with oseltamivir in patients who were infected with H1pdm09 or type B virus and who developed respiratory distress. A systemic corticosteroid should be administered after initiating NAI therapy, especially in patients with chronic lung disease.
Copyright ? 2015. Published by Elsevier B.V.
[h=4]KEYWORDS:[/h] H1N1; corticosteroid; influenza; oseltamivir; peramivir
PMID: 26542650 [PubMed - as supplied by publisher]
[h=1]Effects of corticosteroid and neuraminidase inhibitors on survival in patients with respiratory distress induced by influenza virus.[/h] Huang SF[SUP]1[/SUP], Fung CP[SUP]2[/SUP], Perng DW[SUP]3[/SUP], Wang FD[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND/PURPOSE:[/h] Neuraminidase inhibitors (NAIs) including oseltamivir and peramivir are used for influenza treatment. A systemic corticosteroid is usually administrated for acute respiratory distress syndrome. The aim of this study was to investigate the effect of a systemic corticosteroid and its interaction with NAIs in patients with influenza infection and respiratory distress.
[h=4]METHODS:[/h] A retrospective survey of hospitalized patients infected with influenza from January 2012 to May 2014 was conducted in a medical center in Taiwan.
[h=4]RESULTS:[/h] Eighty-six patients were hospitalized during the study period. Forty-eight patients had respiratory distress and 39 of them (81.3%, 39/48) were supported by a mechanical ventilator. All patients with respiratory distress received oseltamivir; 60.4% (29/48) and 31.3% (15/48) of them received a corticosteroid and salvage intravenous peramivir, respectively. All-cause mortality was 29.1% (14/48), 20% (3/15), and 31% (9/29) in patients with respiratory distress, patients who received salvage peramivir, and patients who received a systemic corticosteroid, respectively. Salvage peramivir seemed to improve prognosis in patients with H1pdm09 or type B virus infection and respiratory distress (p = 0.05). Early initiating corticosteroid had a worse prognosis than initiation after 72 hours of NAI treatment (p = 0.024). In particular, a systemic corticosteroid seemed to lead to a shorter survival time in patients with chronic lung disease (p = 0.05).
[h=4]CONCLUSION:[/h] Salvage peramivir provided a better prognosis than monotherapy with oseltamivir in patients who were infected with H1pdm09 or type B virus and who developed respiratory distress. A systemic corticosteroid should be administered after initiating NAI therapy, especially in patients with chronic lung disease.
Copyright ? 2015. Published by Elsevier B.V.
[h=4]KEYWORDS:[/h] H1N1; corticosteroid; influenza; oseltamivir; peramivir
PMID: 26542650 [PubMed - as supplied by publisher]