Intravenous peramivir vs oral oseltamivir in high‐risk emergency department patients with influenza: Results from a pilot randomized controlled study
| Autor: | Kathryn Saliba-Shaw, Breana McBryde, Yu Hsiang Hsieh, Frank LoVecchio, Erin P. Ricketts, Richard E. Rothman, Andrea Dugas |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Oseltamivir emergency department oseltamivir Epidemiology Acids Carbocyclic Pilot Projects Cyclopentanes Antiviral Agents Guanidines peramivir law.invention chemistry.chemical_compound Randomized controlled trial law Internal medicine Influenza Human medicine Humans Dosing Adult patients business.industry Public Health Environmental and Occupational Health virus diseases Treatment options Original Articles Emergency department medicine.disease respiratory tract diseases Pneumonia Treatment Outcome Infectious Diseases chemistry Original Article Peramivir influenza Emergency Service Hospital business medicine.drug |
| Zdroj: | Influenza and Other Respiratory Viruses |
| ISSN: | 1750-2659 1750-2640 |
| DOI: | 10.1111/irv.12794 |
| Popis: | Background Peramivir offers a single‐dose intravenous (IV) treatment option for influenza (vs 5‐day oral dosing for oseltamivir). We sought to compare outcomes of emergency department (ED) patients at high risk for influenza complications treated with IV peramivir vs oral oseltamivir. Methods During the 2015‐16 and 2016‐17 influenza seasons, adult patients in two US EDs were randomized to either oral oseltamivir or IV peramivir treatment group. Eligibility included positive molecular influenza test; met CDC criteria for antiviral treatment; able to provide informed consent and agree to follow‐up assessment. Outcomes were measured by clinical end‐point indicators, including FLU‐PRO Score, Ordinal Scale, Patient Global Impression on Severity Score, and Karnofsky Performance Scale for 14 days. Non‐inferior t test was performed to assess comparative outcomes between the two groups. Results Five hundred and seventy‐five (68%) of 847 influenza‐positive patients were approached. Two hundred and eighty‐four met enrollment criteria and 179 were enrolled; of these 95 (53%) were randomized to peramivir, and 84 to oseltamivir. Average FLU‐PRO score at baseline was similar (peramivir: 2.67 vs oseltamivir: 2.52); the score decreased over time for both groups (day 5: peramivir: 1.71 vs oseltamivir: 1.62; day 10: peramivir: 1.48 vs oseltamivir: 1.37; day 14: peramivir: 1.40 vs oseltamivir: 1.33; all P .05; pneumonia: peramivir: 11% vs oseltamivir: 14%, P > .05). Conclusions Clinical outcomes of influenza‐infected patients treated with single‐dose IV peramivir were comparable to those treated with oral oseltamivir, suggesting potential utility of peramivir for influenza‐infected patients in the ED. |
| Databáze: | OpenAIRE |
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