tetano
Editor, Senior Moderator
Antivir Ther. 2012 Jun 7. doi: 10.3851/IMP2128. [Epub ahead of print]
Effect of oseltamivir, zanamivir or oseltamivir-zanamivir combination treatments on transmission of influenza in households.
Carrat F, Duval X, Tubach F, Mosnier A, Van der Werf S, Tibi A, Blanchon T, Leport C, Flahault A, Mentr? F; the BIVIR study group.
Source
APHP, H?pital Saint-Antoine, Unit? de Sant? Publique, Paris, France. carrat@u707.jussieu.fr.
Abstract
BACKGROUND:
The effectiveness of neuraminidase inhibitors to reduce transmission when used as treatment in influenza-infected patients remains debated.
METHODS:
In a prespecified analysis of a blinded randomized controlled trial on the efficacy of oseltamivir-zanamivir combination therapy versus oseltamivir and zanamivir monotherapy conducted during the 2008-2009 seasonal influenza epidemic, we compared the rate of secondary illness in household contacts of influenza-positive index patients between arms. Secondary illness was defined as occurrence in contacts of fever plus cough within 7 days from randomization of index patients. Analyses were conducted according to the delay between patients' onset of symptoms and intervention.
RESULTS:
A total of 543 household contacts of 267 index patients were included, of which 466 had follow-up assessment. A secondary illness was reported in 58 (12.5%) contacts with no significant difference between arms overall (P=0.07). When the analysis was limited to the 232 contacts of 136 index patients with first treatment intake within 24 h of onset of symptoms, a lower rate of secondary illness was reported in the combination therapy arm (2 of 56 [4%]) than in the oseltamivir arm (14 of 81 [17%]; P=0.014) and the zanamivir arm (14 of 95 [15%]; P=0.031). Multivariate analysis accounting for intra-household correlation confirmed these findings.
CONCLUSIONS:
Our analysis suggests a greater effectiveness of the combination therapy to reduce transmissibility when given to the index patient within 24 h of onset of symptoms. As the finding was obtained from a subgroup analysis, it should be interpreted with caution.
PMID:
22910171
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22910171
Effect of oseltamivir, zanamivir or oseltamivir-zanamivir combination treatments on transmission of influenza in households.
Carrat F, Duval X, Tubach F, Mosnier A, Van der Werf S, Tibi A, Blanchon T, Leport C, Flahault A, Mentr? F; the BIVIR study group.
Source
APHP, H?pital Saint-Antoine, Unit? de Sant? Publique, Paris, France. carrat@u707.jussieu.fr.
Abstract
BACKGROUND:
The effectiveness of neuraminidase inhibitors to reduce transmission when used as treatment in influenza-infected patients remains debated.
METHODS:
In a prespecified analysis of a blinded randomized controlled trial on the efficacy of oseltamivir-zanamivir combination therapy versus oseltamivir and zanamivir monotherapy conducted during the 2008-2009 seasonal influenza epidemic, we compared the rate of secondary illness in household contacts of influenza-positive index patients between arms. Secondary illness was defined as occurrence in contacts of fever plus cough within 7 days from randomization of index patients. Analyses were conducted according to the delay between patients' onset of symptoms and intervention.
RESULTS:
A total of 543 household contacts of 267 index patients were included, of which 466 had follow-up assessment. A secondary illness was reported in 58 (12.5%) contacts with no significant difference between arms overall (P=0.07). When the analysis was limited to the 232 contacts of 136 index patients with first treatment intake within 24 h of onset of symptoms, a lower rate of secondary illness was reported in the combination therapy arm (2 of 56 [4%]) than in the oseltamivir arm (14 of 81 [17%]; P=0.014) and the zanamivir arm (14 of 95 [15%]; P=0.031). Multivariate analysis accounting for intra-household correlation confirmed these findings.
CONCLUSIONS:
Our analysis suggests a greater effectiveness of the combination therapy to reduce transmissibility when given to the index patient within 24 h of onset of symptoms. As the finding was obtained from a subgroup analysis, it should be interpreted with caution.
PMID:
22910171
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22910171