Details:

Alternative Title:
PLoS One
Personal Author:
Louie, Janice K. ; Yang, Samuel ; Yen, Cynthia ; Acosta, Meileen ; Schechter, Robert ; ... More +
Louie, Janice K. ; Yang, Samuel ; Yen, Cynthia ; Acosta, Meileen ; Schechter, Robert ; Uyeki, Timothy M. Less -
Description:
Oral antiviral agents to treat influenza are challenging to administer in the intensive care unit (ICU). We describe 57 critically ill patients treated with the investigational intravenous neuraminidase inhibitor drug peramivir for influenza A (H1N1)pdm09 [pH1N1]. Most received late peramivir treatment following clinical deterioration in the ICU on enterically-administered oseltamivir therapy. The median age was 40 years (range 5 months-81 years). Common clinical complications included pneumonia or acute respiratory distress syndrome requiring mechanical ventilation (54; 95%), sepsis requiring vasopressor support (34/53; 64%), acute renal failure requiring hemodialysis (19/53; 36%) and secondary bacterial infection (14; 25%). Over half (29; 51%) died. When comparing the 57 peramivir-treated cases with 1627 critically ill cases who did not receive peramivir, peramivir recipients were more likely to be diagnosed with pneumonia/acute respiratory distress syndrome (p = 0.0002) or sepsis (p = <0.0001), require mechanical ventilation (p = <0.0001) or die (p = <0.0001). The high mortality could be due to the pre-existing clinical severity of cases prior to request for peramivir, but also raises questions about peramivir safety and effectiveness in hospitalized and critically ill patients. The use of peramivir merits further study in randomized controlled trials, or by use of methods such as propensity scoring and matching, to assess clinical effectiveness and safety.
Subjects:
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Administration, Intravenous Adolescent Adult Aged Aged, 80 And Over Antiviral Agents Child Child, Preschool Critical Illness Cyclopentanes Female Guanidines Humans Infant Infant, Newborn Influenza, Human Influenza A Virus, H1N1 Subtype Male Middle Aged Pandemics Retrospective Studies Severity Of Illness Index Young Adult
Source:
PLoS One. 2012; 7(6).
Document Type:
Journal Article
Place as Subject:
California
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:c7b2372297924ef35238b946bfee9c0bc258f6b2e3f43c689d2259465273f55e
Download URL:
https://stacks.cdc.gov/view/cdc/10887/cdc_10887_DS1.pdf
File Type:

Supporting Files

• 	license.txt	txt
  	pone.0040261.nxml	txt
  	pone.0040261.t001.gif	gif
  	pone.0040261.t001.jpg	jpeg

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