tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2011 Dec 6. doi: 10.1111/j.1469-0691.2011.03751.x. [Epub ahead of print]
Factors associated with clinical and virological response in patients treated with oseltamivir or zanamivir for influenza A during the 2008-2009 winter.
Blanchon T, Mentr? F, Charlois-Ou C, Dornic Q, Mosnier A, Bouscambert M, Carrat F, Duval X, Enouf V, Leport C; the Bivir Study Group.
Source
INSERM, U707, Paris UPMC Univ Paris 06, UMR_S 707, Paris Univ Paris Diderot, Sorbonne Paris Cit?, UMR 738, Paris INSERM, UMR 738, Paris APHP, H?pital Bichat, Unit? de Biostatistiques, Paris R?seau des Groupes R?gionaux d'Observation de la Grippe (GROG), Coordination Nationale, Paris Hospices Civils de Lyon, Centre National de R?f?rence des Virus Influenzae (R?gion-Sud), GHE, Bron UCBL, Universit? Lyon 1, VirPatH, CNRS FRE 3011, Lyon Assistance Publique, H?pitaux de Paris, H?pital Saint-Antoine, Unit? de Sant? Publique, Paris INSERA CIC 007, APHP, H?pital Bichat, Paris Institut Pasteur, Centre National de R?f?rence des Virus Influenzae (R?gion-Nord), Unit? de G?n?tique Mol?culaire des Virus ? ARN, Paris APHP, Unit? de Coordination des Risques Epid?miques et Biologiques, Paris, France.
Abstract
Clin Microbiol Infect ABSTRACT: Oseltamivir or zanamivir are effective in outpatients with seasonal influenza; however, factors associated with response have been incompletely described. During the 2008/2009 epidemic, in a randomized trial for influenza A-infected outpatients, clinical (time to alleviation of flu-related symptoms) and virological (rate of patients with day 2 nasal viral load <200 cgeq/μL) responses to oseltamivir or zanamivir were assessed and associated factors were determined using multivariate analysis. For oseltamivir (141 patients) and zanamivir (149 patients) median times to alleviation of symptoms were 3 and 4 days, respectively; 59% and 34% had virological response. For oseltamivir, a lower clinical response was associated with female gender (HR, 0.53; 95% CI, 0.36-0.79), baseline symptoms score >14 (HR, 0.47; 0.32-0.70), viral load ≥5 log cgeq/μL (HR, 0.63; 0.43-0.93), and initiation of antibiotics (HR, 0.30; 0.12-0.76); a lower virological response was associated with female gender (OR, 0.45; 0.21-0.96), baseline viral load ≥5 log cgeq/μL (OR, 0.40; 0.20-0.84) and days 0-2 incomplete compliance (OR, 0.31; 0.10-0.98). For zanamivir, virological response was associated with age ≥50 years (OR, 0.29; 0.10-0.85) and initiation of antibiotics at baseline (OR, 4.24; 1.07-17.50). Factors associated with lower response to neuraminidase inhibitors in outpatients appeared to be easily identifiable during routine clinical examination and, when appropriate, by nasal sampling at baseline. The unknown association between gender and response to oseltamivir was not explained by compliance.
? 2011 The Authors. Clinical Microbiology and Infection ? 2011 European Society of Clinical Microbiology and Infectious Diseases.
PMID:
22264308
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22264308
Factors associated with clinical and virological response in patients treated with oseltamivir or zanamivir for influenza A during the 2008-2009 winter.
Blanchon T, Mentr? F, Charlois-Ou C, Dornic Q, Mosnier A, Bouscambert M, Carrat F, Duval X, Enouf V, Leport C; the Bivir Study Group.
Source
INSERM, U707, Paris UPMC Univ Paris 06, UMR_S 707, Paris Univ Paris Diderot, Sorbonne Paris Cit?, UMR 738, Paris INSERM, UMR 738, Paris APHP, H?pital Bichat, Unit? de Biostatistiques, Paris R?seau des Groupes R?gionaux d'Observation de la Grippe (GROG), Coordination Nationale, Paris Hospices Civils de Lyon, Centre National de R?f?rence des Virus Influenzae (R?gion-Sud), GHE, Bron UCBL, Universit? Lyon 1, VirPatH, CNRS FRE 3011, Lyon Assistance Publique, H?pitaux de Paris, H?pital Saint-Antoine, Unit? de Sant? Publique, Paris INSERA CIC 007, APHP, H?pital Bichat, Paris Institut Pasteur, Centre National de R?f?rence des Virus Influenzae (R?gion-Nord), Unit? de G?n?tique Mol?culaire des Virus ? ARN, Paris APHP, Unit? de Coordination des Risques Epid?miques et Biologiques, Paris, France.
Abstract
Clin Microbiol Infect ABSTRACT: Oseltamivir or zanamivir are effective in outpatients with seasonal influenza; however, factors associated with response have been incompletely described. During the 2008/2009 epidemic, in a randomized trial for influenza A-infected outpatients, clinical (time to alleviation of flu-related symptoms) and virological (rate of patients with day 2 nasal viral load <200 cgeq/μL) responses to oseltamivir or zanamivir were assessed and associated factors were determined using multivariate analysis. For oseltamivir (141 patients) and zanamivir (149 patients) median times to alleviation of symptoms were 3 and 4 days, respectively; 59% and 34% had virological response. For oseltamivir, a lower clinical response was associated with female gender (HR, 0.53; 95% CI, 0.36-0.79), baseline symptoms score >14 (HR, 0.47; 0.32-0.70), viral load ≥5 log cgeq/μL (HR, 0.63; 0.43-0.93), and initiation of antibiotics (HR, 0.30; 0.12-0.76); a lower virological response was associated with female gender (OR, 0.45; 0.21-0.96), baseline viral load ≥5 log cgeq/μL (OR, 0.40; 0.20-0.84) and days 0-2 incomplete compliance (OR, 0.31; 0.10-0.98). For zanamivir, virological response was associated with age ≥50 years (OR, 0.29; 0.10-0.85) and initiation of antibiotics at baseline (OR, 4.24; 1.07-17.50). Factors associated with lower response to neuraminidase inhibitors in outpatients appeared to be easily identifiable during routine clinical examination and, when appropriate, by nasal sampling at baseline. The unknown association between gender and response to oseltamivir was not explained by compliance.
? 2011 The Authors. Clinical Microbiology and Infection ? 2011 European Society of Clinical Microbiology and Infectious Diseases.
PMID:
22264308
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22264308