tetano
Editor, Senior Moderator
Early therapy with neuraminidase inhibitors on influenza A (H1N1) pdm 2009 infections (R1)
Takehisa Yamamoto MD1,*,
Mai Ihashi MD1,
Yoshimi Mizoguchi MD1,
Hiroshi Kaneno MD1,
Katsusuke Yamamoto MD1,
Yutaka Inoue2,
Tetsuo Kase MD3,
Nobuhiko Okabe4,
Tsunesuke Shimotsuji MD1
DOI: 10.1111/ped.12154
Abstract
Background
Neuraminidase inhibitors were reported to decrease mortality in patients infected with influenza A (H1N1) pdm 2009 (H1N1 pdm09). However, it is not clear whether they are effective against H1N1pdm 09 in apparently healthy children.
Methods
We investigated the early administrative effect of neuraminidase inhibitors on 70 healthy children with possible H1N1 pdm09 (pH1N1pdm09) infections. They were simultaneously treated with a neuraminidase inhibitor (oseltamivir or zanamivir) and maoto; a Japanese traditional herbal medicine, which had been reported to be effective against seasonal influenza. Clinical severity was assessed using patient histories, namely the worst values for clinical vital signs and laboratory data on admission. After refining these parameters with univariate, decision tree and multiple regression analyses, we used a mean covariance structure equation analysis to investigate the association of estimated clinical severity to the selected parameters.
Results
Total path analyses using a Bayesian method revealed the estimated clinical severity of pH1N1 pdm09 to be positively associated with maximal body temperature, pulse rate, respiration rate, duration necessary for defervescence, admission duration and log urinary beta 2 microglobulin/creatinine levels, and negatively associated with age and the presence and duration of treatment with the neuraminidase inhibitor in outpatient clinics.
Conclusions
This study provides the first clinical evidence that early treatment with neuraminidase inhibitors in outpatient clinics decreased the estimated clinical severity of pH1N1 pdm09 in apparently healthy pediatric inpatients.
http://onlinelibrary.wiley.com/doi/...ionid=FA426D38ECA1B2CB6C3BEC0E70CA6427.d03t01
Takehisa Yamamoto MD1,*,
Mai Ihashi MD1,
Yoshimi Mizoguchi MD1,
Hiroshi Kaneno MD1,
Katsusuke Yamamoto MD1,
Yutaka Inoue2,
Tetsuo Kase MD3,
Nobuhiko Okabe4,
Tsunesuke Shimotsuji MD1
DOI: 10.1111/ped.12154
Abstract
Background
Neuraminidase inhibitors were reported to decrease mortality in patients infected with influenza A (H1N1) pdm 2009 (H1N1 pdm09). However, it is not clear whether they are effective against H1N1pdm 09 in apparently healthy children.
Methods
We investigated the early administrative effect of neuraminidase inhibitors on 70 healthy children with possible H1N1 pdm09 (pH1N1pdm09) infections. They were simultaneously treated with a neuraminidase inhibitor (oseltamivir or zanamivir) and maoto; a Japanese traditional herbal medicine, which had been reported to be effective against seasonal influenza. Clinical severity was assessed using patient histories, namely the worst values for clinical vital signs and laboratory data on admission. After refining these parameters with univariate, decision tree and multiple regression analyses, we used a mean covariance structure equation analysis to investigate the association of estimated clinical severity to the selected parameters.
Results
Total path analyses using a Bayesian method revealed the estimated clinical severity of pH1N1 pdm09 to be positively associated with maximal body temperature, pulse rate, respiration rate, duration necessary for defervescence, admission duration and log urinary beta 2 microglobulin/creatinine levels, and negatively associated with age and the presence and duration of treatment with the neuraminidase inhibitor in outpatient clinics.
Conclusions
This study provides the first clinical evidence that early treatment with neuraminidase inhibitors in outpatient clinics decreased the estimated clinical severity of pH1N1 pdm09 in apparently healthy pediatric inpatients.
http://onlinelibrary.wiley.com/doi/...ionid=FA426D38ECA1B2CB6C3BEC0E70CA6427.d03t01