Lower clinical effectiveness of oseltamivir against influenza B contrasted with influenza a infection in children

被引:140
作者
Sugaya, Norio
Mitamura, Keiko
Yamazaki, Masahiko
Tamura, Daisuke
Ichikawa, Masataka
Kimura, Kazuhiro
Kawakami, Chiharu
Kiso, Maki
Ito, Mutsumi
Hatakeyama, Shuji
Kawaoka, Yoshihiro
机构
[1] Keiyu Hosp, Dept Pediat, Nishi Ku, Yokohama, Kanagawa 2200012, Japan
[2] Yokohama City Inst Hlth, Yokohama, Kanagawa, Japan
[3] Univ Tokyo, Grad Sch Med, Eiju Gen Hosp, Dept Pediat, Tokyo, Japan
[4] Univ Tokyo, Grad Sch Med, Dept Microbiol & Immunol, Div Virol, Tokyo, Japan
[5] Univ Tokyo, Grad Sch Med, Int Ctr Infect Dis, Inst Med Sci, Tokyo, Japan
[6] Univ Tokyo, Grad Sch Med, Dept Infect Dis, Tokyo, Japan
[7] Isehara Kyodo Hosp, Dept Pediat, Isehara, Kanagawa, Japan
[8] Univ Wisconsin, Sch Vet Med, Dept Pathobiol Sci, Madison, WI 53706 USA
关键词
D O I
10.1086/509925
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Recently, many Japanese physicians have claimed that oseltamivir is less effective in children with influenza B virus infection. This study assesses the effectiveness of oseltamivir against influenza A (H3N2) and influenza B in children on the basis of the duration of febrile illness. Methods. We used oseltamivir to treat 127 children with influenza A (H3N2; mean age, 6.97 years [ range, 1 15 years]) and 362 children with influenza B (mean age, 5.16 years [range, 1-15 years]) in outpatient clinics. The duration of fever after the start of oseltamivir therapy was compared in the influenza A group and the influenza B group. Results. The mean duration of fever after the start of oseltamivir therapy was significantly greater in the influenza B group than in the influenza A (H3N2) group (2.18 days vs. 1.31 days, respectively;). The P <.001 difference was marked in young children (1-5 years old; 2.37 days for the influenza B group vs. 1.42 days for the influenza A group) but was not significant among older children (11-15 years old). The 50% inhibitory concentration of oseltamivir against influenza B virus was nmol/L and was substantially higher than that for 75.4 +/- 41.7 type A (H3N2) virus (nmol/L). Only 3 (1.6%) of 192 influenza B viruses were resistant to oseltamivir. 0.3 +/- 0.1 Conclusions. Oseltamivir is much less effective against influenza B virus infection in young children, probably because of the low sensitivity of influenza B viruses to oseltamivir. The effectiveness of oseltamivir against influenza B is influenced by age and host immunity. A few oseltamivir-resistant influenza B strains were isolated before the start of oseltamivir therapy.
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页码:197 / 202
页数:6
相关论文
共 25 条
[21]   Cost of neuraminidase inhibitor-use is offset by a reduction in inappropriate antibiotic-use [J].
Sugaya, N ;
Mitamura, K .
OPTIONS FOR THE CONTROL OF INFLUENZA V, 2004, 1263 :118-121
[22]   IMPACT OF INFLUENZA-VIRUS INFECTION AS A CAUSE OF PEDIATRIC HOSPITALIZATION [J].
SUGAYA, N ;
NEROME, K ;
ISHIDA, M ;
NEROME, R ;
NAGAE, M ;
TAKEUCHI, Y ;
OSANO, M .
JOURNAL OF INFECTIOUS DISEASES, 1992, 165 (02) :373-375
[23]  
SUGAYA N, 2005, 2 EUR INFL C MALT AN, P38
[24]   Oral oseltamivir treatment of influenza in children [J].
Whitley, RJ ;
Hayden, FG ;
Reisinger, KS ;
Young, N ;
Dutkowski, R ;
Ipe, D ;
Mills, RG ;
Ward, P .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2001, 20 (02) :127-133
[25]  
WRIGHT P, 2005, TXB PEDIAT, P1072