tetano
Editor, Senior Moderator
Oxford Journals
Medicine
Journal of Infectious Diseases
Volume204, Issue5
Pp. 777-782.
Evaluation of the Antiviral Response to Zanamivir Administered Intravenously for Treatment of Critically Ill Patients With Pandemic Influenza A (H1N1) Infection
P. L. A. Fraaij1,2,
E. van der Vries1,
M. F. C. Beersma1,
A. Riezebos-Brilman3,
H. G. M. Niesters3,
A. A. van der Eijk1,
M. D. de Jong4,
D. Reis Miranda5,
A. M. Horrevorts6,
B. U. Ridwan7,
M. J. H. M. Wolfhagen8,
R. J. Houmes2,
J. T. van Dissel9,
R. A. M. Fouchier1,
A. C. M. Kroes9,
M. P. Koopmans10,
A. D. M. E. Osterhaus1 and
C. A. B Boucher1
1Department of Virology, Erasmus MC
2Intensive Care and Department of Pediatric Surgery and Pediatrics, Erasmus MC?Sophia Children?s Hospital, Rotterdam
3Department of Medical Microbiology, Division of Clinical Virology, University Medical Center Groningen
4Department of Medical Microbiology and Infectious Diseases, Academic Medical Center, University of Amsterdam
5Department of Intensive Care, Erasmus MC, Rotterdam
6Department of Medical Microbiology and Infectious Diseases Canisius?Wilhelmina Hospital, Nijmegen
7Department of Medical Microbiology, Westfriesgasthuis, Hoorn
8Laboratory of Medical Microbiology and Infectious Diseases, Isala Clinics, Zwolle
9Center for Infectious Diseases, Leiden University Medical Center
10Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Correspondence: Pieter L. A. Fraaij, MD, PhD, Department of Virology, Erasmus MC, Dr Molewaterplein 60, Rotterdam, Postbus 2040, the Netherlands (p.fraaij{at}erasmusmc.nl).
Abstract
A retrospective nationwide study on the use of intravenous (IV) zanamivir in patients receiving intensive care who were pretreated with oseltamivir in the Netherlands was performed. In 6 of 13 patients with a sustained reduction of the viral load, the median time to start IV zanamivir was 9 days (range, 4?11 days) compared with 14 days (range, 6?21 days) in 7 patients without viral load reduction (P = .052). Viral load response did not influence mortality. We conclude that IV zanamivir as late add-on therapy has limited effectiveness. The effect of an immediate start with IV zanamivir monotherapy or in combination with other drugs need to be evaluated.
http://jid.oxfordjournals.org/content/204/5/777.abstract
Medicine
Journal of Infectious Diseases
Volume204, Issue5
Pp. 777-782.
Evaluation of the Antiviral Response to Zanamivir Administered Intravenously for Treatment of Critically Ill Patients With Pandemic Influenza A (H1N1) Infection
P. L. A. Fraaij1,2,
E. van der Vries1,
M. F. C. Beersma1,
A. Riezebos-Brilman3,
H. G. M. Niesters3,
A. A. van der Eijk1,
M. D. de Jong4,
D. Reis Miranda5,
A. M. Horrevorts6,
B. U. Ridwan7,
M. J. H. M. Wolfhagen8,
R. J. Houmes2,
J. T. van Dissel9,
R. A. M. Fouchier1,
A. C. M. Kroes9,
M. P. Koopmans10,
A. D. M. E. Osterhaus1 and
C. A. B Boucher1
1Department of Virology, Erasmus MC
2Intensive Care and Department of Pediatric Surgery and Pediatrics, Erasmus MC?Sophia Children?s Hospital, Rotterdam
3Department of Medical Microbiology, Division of Clinical Virology, University Medical Center Groningen
4Department of Medical Microbiology and Infectious Diseases, Academic Medical Center, University of Amsterdam
5Department of Intensive Care, Erasmus MC, Rotterdam
6Department of Medical Microbiology and Infectious Diseases Canisius?Wilhelmina Hospital, Nijmegen
7Department of Medical Microbiology, Westfriesgasthuis, Hoorn
8Laboratory of Medical Microbiology and Infectious Diseases, Isala Clinics, Zwolle
9Center for Infectious Diseases, Leiden University Medical Center
10Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Correspondence: Pieter L. A. Fraaij, MD, PhD, Department of Virology, Erasmus MC, Dr Molewaterplein 60, Rotterdam, Postbus 2040, the Netherlands (p.fraaij{at}erasmusmc.nl).
Abstract
A retrospective nationwide study on the use of intravenous (IV) zanamivir in patients receiving intensive care who were pretreated with oseltamivir in the Netherlands was performed. In 6 of 13 patients with a sustained reduction of the viral load, the median time to start IV zanamivir was 9 days (range, 4?11 days) compared with 14 days (range, 6?21 days) in 7 patients without viral load reduction (P = .052). Viral load response did not influence mortality. We conclude that IV zanamivir as late add-on therapy has limited effectiveness. The effect of an immediate start with IV zanamivir monotherapy or in combination with other drugs need to be evaluated.
http://jid.oxfordjournals.org/content/204/5/777.abstract