Jama: Use of Intravenous Neuraminidase Inhibitors During the 2009 Pandemic: Results From Population-Based Surveillance

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Research Letter
JAMA. 2011;306(2):160-162. doi: 10.1001/jama.2011.950
Use of Intravenous Neuraminidase Inhibitors During the 2009 Pandemic: Results From Population-Based Surveillance

Alicia M. Fry, MD, MPH;
Alejandro P?rez, MPH;
Lyn Finelli, DPH

Since this article does not have an abstract, we have provided the first 150 words of the full text.




To the Editor: During 2009, neuraminidase inhibitors (NAIs) were recommended for treatment of pandemic influenza A virus (pH1N1) infection 1; oral oseltamivir and inhaled zanamivir are the only licensed NAIs in the United States. During the pandemic, 2 experimental intravenous (IV) NAIs, zanamivir and peramivir, were available by emergency investigational new drug or emergency use authorization request. 2, 3 We report the frequency and characteristics of patients who received an experimental IV NAI from a population-based, active surveillance of hospitalized patients.
Methods

We identified patients with laboratory-confirmed pH1N1 infection from the Emerging Infections Program Influenza-Associated Hospitalization Surveillance. The surveillance area includes 22 million adults and children from select counties in 10 states that represent approximately 7% of the US population. 4, 5 Hospitalization associated with pH1N1 was defined as laboratory-confirmed influenza (pH1N1 or influenza A unsubtyped) in a patient admitted to a hospital in the surveillance area between ?


http://jama.ama-assn.org/content/306/2/160.extract

 

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Re: Jama: Use of Intravenous Neuraminidase Inhibitors During the 2009 Pandemic: Results From Population-Based Surveillance

Report shows rarity of IV antiviral use during 2009 pandemic
A letter report in today's Journal of the American Medical Association makes clear how rarely intravenous (IV) antiviral drugs were used during the 2009 H1N1 influenza pandemic. Two IV antivirals, zanamivir and peramivir, were made available under emergency investigational new drug and emergency use authorization rules. Researchers from the Centers for Disease Control and Prevention (CDC) gathered data on use of the drugs through the Emerging Infections Program, using a surveillance area including selected counties in 10 states and having a population of about 2.2 million. They identified 7,759 patients with confirmed 2009 H1N1 who were hospitalized between April 2009 and April 2010. Of 6,216 (80%) patients who received an antiviral, only 41, including 38 adults and 3 children, received an IV drug. Peramivir was used in 33 patients and zanamivir in 8. A shortage of data on effectiveness and safety in severely ill patients and children may have discouraged use of the IV formulations, the report says. Death rates were 27% (11 of 41) in patients who received the IV drugs and 3% (174 of 6,175) in those treated with the licensed drugs. But the researchers say they could not assess the effectiveness of the medications, as those who received them tended to be more severely ill and obese, and no adequate comparison group was available.
Jul 13 JAMA letter report

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jul1311fluscan.html