Serveur d'exploration sur la grippe au Canada

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Utility of zanamivir for chemoprophylaxis of concomitant influenza A and B in a complex continuing care population.

Identifieur interne : 000A39 ( Main/Exploration ); précédent : 000A38; suivant : 000A40

Utility of zanamivir for chemoprophylaxis of concomitant influenza A and B in a complex continuing care population.

Auteurs : Z. Hirji [Canada] ; S. O'Grady ; J. Bonham ; M. Mak ; J. Takata-Shewchuk ; K. Hawkins ; M. Gardam ; L. Law ; T. Mazzulli ; J. Conly

Source :

RBID : pubmed:12400891

Descripteurs français

English descriptors

Abstract

OBJECTIVE

To describe compliance with and the safety and prophylactic efficacy of zanamivir among patients at risk of developing influenza-related complications after exposure to both influenza A and B viruses.

DESIGN

Nonrandomized trial using both historical and contemporaneous controls from ward populations within the same facility.

SETTING

A 547-bed urban hospital providing complex continuing care and rehabiltation.

PATIENTS

Fifty patients on a single ward concomitantly exposed to both influenza A and B during an influenza outbreak.

INTERVENTIONS

All patients were screened for symptoms of influenza and nasopharyngeal swabs were sent for viral culture prior to treatment (two oral inhalations [2 x 5 mg] twice daily for 5 days) or prophylaxis (two oral inhalations [2 x 5 mg] once daily for 14 days) with zanamivir. Patient symptoms, compliance, and drug tolerance were monitored daily. Demographic data, comorbidities, vaccination status, and functional status (Katz score) were collected for all patients.

RESULTS

The mean age of the patients was 70.6 years (standard deviation, +/- 16.4 years). Ninety-four percent had two or more comorbidities, 71% were dependent in two or more activities of daily living, 63% had been vaccinated for influenza, and 82% had received amantadine. Zanamivir was well tolerated, with 93% of the patients completing their course. The efficacy for preventing symptomatic infection was 82% and 91% (95% confidence interval, 62% to 98%) based on historical and contemporaneous controls, respectively.

CONCLUSION

These data suggest that zanamivir can be used safely and effectively as a prophylactic agent in the management of influenza outbreaks in a complex continuing care population with multiple comorbidities.


DOI: 10.1086/501979
PubMed: 12400891


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Antiviral Agents (therapeutic use)</term>
<term>Comorbidity (MeSH)</term>
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<term>Cross Infection (virology)</term>
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<term>Influenza, Human (drug therapy)</term>
<term>Influenza, Human (prevention & control)</term>
<term>Influenza, Human (virology)</term>
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<term>Premedication (MeSH)</term>
<term>Pyrans (MeSH)</term>
<term>Rehabilitation Centers (organization & administration)</term>
<term>Safety (MeSH)</term>
<term>Sialic Acids (adverse effects)</term>
<term>Sialic Acids (therapeutic use)</term>
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<term>Grippe humaine (traitement médicamenteux)</term>
<term>Grippe humaine (virologie)</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>To describe compliance with and the safety and prophylactic efficacy of zanamivir among patients at risk of developing influenza-related complications after exposure to both influenza A and B viruses.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>DESIGN</b>
</p>
<p>Nonrandomized trial using both historical and contemporaneous controls from ward populations within the same facility.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SETTING</b>
</p>
<p>A 547-bed urban hospital providing complex continuing care and rehabiltation.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PATIENTS</b>
</p>
<p>Fifty patients on a single ward concomitantly exposed to both influenza A and B during an influenza outbreak.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERVENTIONS</b>
</p>
<p>All patients were screened for symptoms of influenza and nasopharyngeal swabs were sent for viral culture prior to treatment (two oral inhalations [2 x 5 mg] twice daily for 5 days) or prophylaxis (two oral inhalations [2 x 5 mg] once daily for 14 days) with zanamivir. Patient symptoms, compliance, and drug tolerance were monitored daily. Demographic data, comorbidities, vaccination status, and functional status (Katz score) were collected for all patients.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>The mean age of the patients was 70.6 years (standard deviation, +/- 16.4 years). Ninety-four percent had two or more comorbidities, 71% were dependent in two or more activities of daily living, 63% had been vaccinated for influenza, and 82% had received amantadine. Zanamivir was well tolerated, with 93% of the patients completing their course. The efficacy for preventing symptomatic infection was 82% and 91% (95% confidence interval, 62% to 98%) based on historical and contemporaneous controls, respectively.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>These data suggest that zanamivir can be used safely and effectively as a prophylactic agent in the management of influenza outbreaks in a complex continuing care population with multiple comorbidities.</p>
</div>
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<DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
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<DescriptorName UI="D053243" MajorTopicYN="N">Zanamivir</DescriptorName>
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<name sortKey="O Grady, S" sort="O Grady, S" uniqKey="O Grady S" first="S" last="O'Grady">S. O'Grady</name>
<name sortKey="Takata Shewchuk, J" sort="Takata Shewchuk, J" uniqKey="Takata Shewchuk J" first="J" last="Takata-Shewchuk">J. Takata-Shewchuk</name>
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<name sortKey="Hirji, Z" sort="Hirji, Z" uniqKey="Hirji Z" first="Z" last="Hirji">Z. Hirji</name>
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</country>
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</record>

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