Oseltamivir and Risk of Lower Respiratory Tract Complications in Patients With Flu Symptoms: A Meta-analysis of Eleven Randomized Clinical Trials
ABSTRACT An independent reanalysis of 11 randomized clinical trials shows that oseltamivir treatment reduces the risk of lower respiratory tract complications requiring antibiotic treatment by 28% overall (95% confidence interval [CI], 11%-42%) and by 37% among patients with confirmed influenza infections (95% CI, 18%-52%).
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ABSTRACT: In an observational study of 582 patients with laboratory-confirmed influenza virus infections, and their household contacts, we found that the initiation of oseltamivir within 24h was associated with shorter duration of self-reported illness symptoms (56% reduction in duration; 95% CI: 41%-67%). However we did not find any association of oseltamivir treatment with duration of viral shedding by PCR, or with the risk of household transmission.The Journal of Infectious Diseases 02/2015; DOI:10.1093/infdis/jiv058 · 5.78 Impact Factor
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ABSTRACT: Following the detection of a novel influenza strain A(H7N9), we modeled the use of antiviral treatment in the United States to mitigate severe disease across a range of hypothetical pandemic scenarios. Our outcomes were total demand for antiviral (neuraminidase inhibitor) treatment and the number of hospitalizations and deaths averted. The model included estimates of attack rate, healthcare-seeking behavior, prescription rates, adherence, disease severity, and the potential effect of antivirals on the risks of hospitalization and death. Based on these inputs, the total antiviral regimens estimated to be available in the United States (as of April 2013) were sufficient to meet treatment needs for the scenarios considered. However, distribution logistics were not examined and should be addressed in future work. Treatment was estimated to avert many severe outcomes (5200-248 000 deaths; 4800-504 000 hospitalizations); however, large numbers remained (25 000-425 000 deaths; 580 000-3 700 000 hospitalizations), suggesting that the impact of combinations of interventions should be examined. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: email@example.com.Clinical Infectious Diseases 05/2015; 60 Suppl 1(suppl 1):S30-41. DOI:10.1093/cid/civ084 · 9.42 Impact Factor
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ABSTRACT: The novel avian influenza A H7N9 virus which caused the first human infection in Shanghai, China; was reported on the 31st of March 2013 before spreading rapidly to other Chinese provinces and municipal cities. This is the first time the low pathogenic avian influenza A virus has caused human infections and deaths; with cases of severe respiratory disease with pneumonia being reported. There were 440 confirmed cases with 122 fatalities by 16 May 2014; with a fatality risk of ∼28%.The median age of patients was 61 years with a male-to-female ratio of 2.4:1. The main source of infection was identified as exposure to poultry and there is so far no definitive evidence of sustained person-to-person transmission. The neuraminidase inhibitors, namely oseltamivir, zanamivir, and peramivir; have shown good efficacy in the management of the novel H7N9 virus. Treatment is recommended for all hospitalized patients, and for confirmed and probable outpatient cases; and should ideally be initiated within 48 h of the onset of illness for the best outcome. Phylogenetic analysis found that the novel H7N9 virus is avian in origin and evolved from multiple reassortments of at least four origins. Indeed the novel H7N9 virus acquired human adaptation via mutations in its eight RNA gene segments. Enhanced surveillance and effective global control are essential to prevent pandemic outbreaks of the novel H7N9 virus.Frontiers in Microbiology 03/2015; 6(140):1-11. DOI:10.3389/fmicb.2015.00140 · 3.94 Impact Factor