A comparison of the effectiveness of oseltamivir for the treatment of influenza A and influenza B: A Japanese multicenter study of the 2003-2004 and 2004-2005 influenza seasons
A comparison of the effectiveness of oseltamivir for the treatment of influenza A and influenza B: A Japanese multicenter study of the 2003-2004 and 2004-2005 influenza seasons
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DOI：
10.1086/505868
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发表时间：
2006-08-15
影响因子：
11.8
通讯作者：
Kashiwagi, Seizaburo
中科院分区：
文献类型：
--
作者：
Kawai, Naoki;Ikematsu, Hideyuki;Kashiwagi, Seizaburo
背景。为了比较奥司他韦治疗甲型流感和乙型流感的有效性，我们对2003-2004年和2004-2005年流感季节进行了一项前瞻性多中心研究。该研究包括3351例通过抗原检测试剂盒诊断为流感的患者。A型流感患者1818例，b型流感患者1485例，A型流感患者21例，b型流感患者27例，未使用抗流感药物。接受奥司他韦治疗的患者根据发热（体温，>= 37.5℃）至首次使用奥司他韦的时间（0 ~ 12 h, 13 ~ 24 h, 25 ~ 36 h, 37 ~ 48 48 h）分为4组。将患者按年龄分为4个亚组（0 ~ 6岁、7 ~ 15岁、16 ~ 64岁、0 ~ 64岁）。44例甲型流感患者和31例乙型流感患者在完成奥司他韦治疗后进行病毒分离。接受奥司他韦治疗的甲型和乙型流感患者的发热持续时间明显短于未接受抗流感药物治疗的患者（P < 0.001）。在0 ~ 12 h、13 ~ 24 h、25 ~ 36 h和37 ~ 48 h组和所有年龄组中，B型流感患者首次给药后发热的时间和发热持续时间均明显长于A型流感患者（P < 0.001）。奥司他韦治疗4 ~ 6 d后，乙型流感病毒再分离率（51.6%）显著高于甲型流感病毒再分离率（15.9%）（P < 0.001）。就发烧持续时间和病毒持续时间而言，奥司他韦对乙型流感的疗效低于对甲型流感的疗效，与患者年龄或首次给药时间无关。
Background. To compare the effectiveness of oseltamivir for treatment of influenza A and influenza B, we conducted a prospective, multicenter study of the 2003-2004 and 2004-2005 influenza seasons. The study included 3351 patients in whom influenza had been diagnosed by use of an antigen detection test kit.Methods. Oseltamivir was administered to 1818 patients with influenza A and 1485 patients with influenza B. No anti-influenza drugs were administered to 21 patients with influenza A or to 27 patients with influenza B. Patients receiving oseltamivir therapy were divided into 4 groups according to the time between the onset of fever (temperature, >= 37.5 degrees C) and administration of the first dose of oseltamivir (0-12 h, 13-24 h, 25-36 h, and 37-48 48 h). The patients were also divided into 4 subgroups on the basis of age (0-6 years, 7-15 years, 16-64 years, and > 64 years). Virus isolation was performed after completion of oseltamivir therapy for 44 patients with influenza A and 31 patients with influenza B.Results. The duration of fever was significantly shorter for patients with influenza A and B who were treated with oseltamivir than for patients who were not treated with an anti-influenza drug (P < .001 for both). The time until the patient became afebrile after the initial administration of oseltamivir and the duration of fever were significantly longer for patients with influenza B than for patients with influenza A for the 0-12 h, 13-24 h, 25 36 36 h, and 37-48 h groups (P < .001) and for all age groups (P < .001). After 4-6 days of oseltamivir therapy, the influenza B virus reisolation rate (51.6%) was significantly higher than the influenza A virus reisolation rate (15.9%) (P < .001)Conclusion. Oseltamivir is less effective for influenza B than for influenza A with regard to duration of fever and virus persistence, irrespective of patient age or the timing of administration of the first dose.