Neuraminidase inhibitors in the management of influenza - experience of an outpatient practice

Abstract

The neuraminidase inhibitors signifies a breakthrough in the treatment of influenza. We compared the outcomes of influenza in 56 patients treated with zanamivir or oseltamivir to a group of 52 influenza patients from the time before these drugs were available. The duration of illness was reduced by 45%, the severity of symptoms by 40% and the administration of antibiotics by 32%. The data from this small group of patients of our ambulatory practice correspond to the results of large randomized placebo-controlled double-blind studies on zanamivir and oseltamivir. Our clinical observations and painful experiences have taught us to take every case of suspected influenza seriously. Since considerable influenza-related complications are common even in otherwise healthy individuals, patients should immediately consult their doctor when an illness with sudden onset of fever and cough or another respiratory symptom occur.

Methodological Considerations for Future Controlled Influenza Treatment Trials in Complementary and Alternative Medicine

“…These include respiratory syncytial virus, adenoviruses, and mycoplasmas, among other infections. 25 As can be seen from the demographics of the influenza studies listed in Table 1, the percentage of patients presenting with ILI who are confirmed by laboratory diagnosis as influenza positive ranges from 57% to 78%, and larger reviews show a typical range of 60%-70%. 25 These ranges are dependent on multiple factors, one of which is the clinical symptombased inclusion criteria used.…”

“…25 As can be seen from the demographics of the influenza studies listed in Table 1, the percentage of patients presenting with ILI who are confirmed by laboratory diagnosis as influenza positive ranges from 57% to 78%, and larger reviews show a typical range of 60%-70%. 25 These ranges are dependent on multiple factors, one of which is the clinical symptombased inclusion criteria used. A 2001 study by Zambon et al 26 reported that of 1033 patients with influenza determined on the basis of clinical symptoms, 77% turned out to be influenza positive in laboratory-confirmed tests.…”

“…In the influenza studies examined, the median number of days until resolution of the illness in the placebo groups was 4 to 8 days after the beginning of the study period. 12,[14][15][16][17][18][19][20][21][22][23]25 If patients are being treated around the end of the disease course, the data may therefore be inconclusive.…”

Management of influenza in primary care practices

“…The accuracy of clinical diagnoses of influenza is enhanced if the infection is known to be circulating in the community. With RealFluk Surveillance, Hoffmann-La Roche has developed an international early warning system for influenza, based on influenza-like illness consultations and near patient tests [6].…”

“…We started the therapy with oseltamivir suspension on 25 February at 9:00 a.m. Seven hours later the temperature was lowered to 38.0 jC, an incredible clinical recovery [2,5,6].…”