Utility of Maoto in an Influenza Season Where Reduced Effectiveness of Oseltamivir Was Observed – a Clinical, Non-Randomized Study in Children

Abstract

Background: In an influenza season where reduced effectiveness of oseltamivir was observed, we investigated the effectiveness of Maoto for influenza infection in children. Methods: Patients diagnosed with influenza by rapid diagnostic kit underwent treatment in one of the following groups: Maoto-treated group (group 1 (M)); oseltamivir-treated group (group 2 (O)); Maoto+oseltamivir-treated group (group 3 (M+O)); zanamivir-treated group (group 4 (Z)); and Maoto+zanamivir-treated group (group 5 (M+Z)). Results: In influenza A patients who completed the study (n = 150), the mean duration of fever after administration (DFA) was significantly shorter in group 3 (M+O) (31.1 h, p < 0.01) and in group 4 (Z) (35.2 h, p < 0.05), as compared to group 2 (O) (56.0 h). Among these, in patients aged ≤5 years (n = 54), DFA was significantly shorter in group 1 (M) (33.2 h, p < 0.05) and in group 3 (M+O) (34.6 h, p < 0.05), as compared to group 2 (O) (61.4 h). In influenza B patients who completed the study (n = 70), no significant differences in DFA were observed among the groups. Conclusion: Maoto may be useful, particularly in cases of influenza with low sensitivity to oseltamivir and in patients aged ≤5 years for whom the use of zanamivir is difficult.

Alleviative Effects of a Kampo (a Japanese Herbal) Medicine “Maoto (Ma‐Huang‐Tang)” on the Early Phase of Influenza Virus Infection and Its Possible Mode of Action

“…It has been reported that maoto had a better reducing effect for the duration of fever in children infected with type A influenza [2, 3]. It has also been reported that the duration of fever in maoto-treated group was shortened significantly rather than in oseltamivir-treated group in adult patients with influenza [4].…”

“…Maoto has been used for the treatment of febrile disease, such as influenza-like illness (high fever, headache, pain, and cough) since ancient times, and has been used frequently for a treatment of early phase of recent influenza virus infections in Japan. Recently, maoto has been reported to have antipyretic effect in pediatric patients [2, 3] and adult patients with type A influenza virus infection [4]. However, the anti-influenza virus activity of maoto has not yet been reported.…”

Ma Huang Tang Suppresses the Production and Expression of Inflammatory Chemokines via Downregulating STAT1 Phosphorylation in HaCaT Keratinocytes

“…Previous research reported that MHT has antipyretic effect in pediatric patients [8]. Other studies showed that MHT has antiasthmatic effects [9].…”

Kampo Medicines for Infectious Diseases

“…The treatment increases antiinfluenza virus IgM, IgA, and IgG1 antibody titers in nasal fluid, bronchoalveolar lavage fluid, and serum, respectively, showing effects similar to those of shoseiryuto. Clinical and randomized studies have also claimed that maoto may be effective in cases of influenza with low sensitivity to oseltamivir and younger patients under 5 years of age (Kubo and Nishimura, 2007;Toriumi et al, 2012).…”