Assessment of efficacy of Oseltamivir-Azithromycin combination therapy in prevention of Influenza-A (H1N1)pdm09 infection complications and rapidity of symptoms relief

Abstract

Objectives: This study aimed to assess the efficacy of oseltamivir-Azithromycin combination therapy for prevention of Influenza-A (H1N1)pdm09 infection associated complications and early relief of influenza symptoms. Methods: In a retrospective observational cohort study, Influenza-A (H1N1)pdm09 infection hospitalized patients were identified and divided into two groups based on the initial therapy. Group-AV patients were initiated on Oseltamivir without any antibiotic in treatment regimen while Group-AV+AZ patients were initiated on Oseltamivir and Azithromycin combination therapy for at least 3-5 days. Patients were evaluated for different clinical outcomes. Results: A total of 227 and 102 patients were identified for Group-AV and Group-AV+AZ respectively. Multivariate regression analysis showed that incidences of secondary bacterial infections were significantly less frequent (23.4% vs 10.4%; P-value = 0.019) in Group-AV+AZ patients. Group-AV+AZ patients were associated with shorter length of hospitalization (6.58 vs 5.09 days; P-value = <0.0001) and less frequent incidences of respiratory support (38.3% vs 17.6%; P-value = 0.016). Overall influenza symptom severity score was statistically significant less for Group-AV+AZ patients on Day-5 (10.68 ± 2.09; P-value = 0.001) of hospitalization. Conclusion: Oseltamivir-Azithromycin combination therapy was found to be more efficacious as compared to oseltamivir alone in rapid recovery and prevention of Influenza associated complications especially in high risk patients.

An Update on Current Therapeutic Drugs Treating COVID-19

“…It binds to the 50S subunit of the bacterial ribosome, thus inhibiting translation of mRNA [72]. Previously, azithromycin has been used as adjunctive therapy to provide antibacterial coverage and potential immunomodulatory and anti-inflammatory effects in the treatment of some viral respiratory tract infections (e.g., influenza) [73,74]. Currently, many trials are testing the effect of azithromycin conjunction with hydroxychloroquine on the course of disease in people with SARS-CoV-2.…”

Efficacy comparison of oseltamivir alone and oseltamivir-antibiotic combination for early resolution of symptoms of severe influenza-A and influenza-B hospitalized patients

“…Total cumulative ARI score (range: 0-24) along with improvement in each of 8 symptoms score on daily basis were analyzed and compared for both group patients of influenza-A (non-H1N1) and influenza-B. 8 Statistical analysis. Continuous variables such as age, weight, and so forth were mentioned in tables and results as mean value plus/minus standard deviation values and univariate analysis was performed using Mann-Whitney-U test/unpaired student T-test.…”

“…Oseltamivir treatment has been proven effective in recovering from influenza illness both in terms of duration and severity in uncomplicated influenza patients. 8 Previously random clinical trials have reported that the duration of symptoms were reduced by approximately one day if oseltamivir was initiated within 48 hours of influenza symptoms onset. 3 One of the characteristics of influenza infection is the elevated levels of pro-inflammatory cytokines.…”

“…6 A randomized clinical trial assessing the oseltamivir-azithromycin combination therapy reported early resolution and rapid recovery of some symptoms associated with severe influenza infection. 7,8 The aim of current study was to assess the comparative efficacy of combination therapy of antiviral drug alone and antiviral-antibiotic combination therapy in early resolution of symptoms associated with severe infected patients with confirmed diagnosis of influenza-A (non-H1N1) and influenza-B hospitalized patients.…”

Repurposing Existing Drugs for the Treatment of COVID-19

“…Two studies assessing the effectiveness of azithromycin when added to oseltamivir in patients with influenza showed evidence of clinical benefit ( 58 , 59 ). Conversely, analysis of a retrospective multicenter cohort of patients with MERS treated with macrolides found no improvement in 90-day mortality or viral clearance ( 60 ).…”