2491. Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers
Identifieur interne : 000B02 ( Main/Exploration ); précédent : 000B01; suivant : 000B032491. Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers
Auteurs : So Yeon Park ; Jin Seo Lee ; Jungok Kim ; Eun-Jeong Joo ; Joong Sik Eom ; Kyong Ran PeckSource :
- Open Forum Infectious Diseases [ 2328-8957 ] ; 2018.
Abstract
In 2015, an outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection occurred in South Korea involving 186 patients, 39 of whom were healthcare workers (HCWs) exposed to the infection. An effective post-exposure prophylaxis (PEP) strategy may limit the spread of infection; however, there is no consensus regarding PEP for MERS-CoV infection. In this study, we assessed (1) the efficacy of oral ribavirin and lopinavir/ritonavir as PEP for HCWs exposed to patients with severe MERS-CoV pre-isolation pneumonia, and (2) safety of the PEP regimen.
We retrospectively enrolled 43 HCWs with high-risk exposure to MERS-CoV from 5 hospitals affected during this outbreak in South Korea. The rate of MERS-CoV infection was compared between 22 workers at 1 hospital who received PEP consisting of oral ribavirin and lopinavir/ritonavir after exposure to patients with severe MERS-CoV pre-isolation pneumonia and 21 workers at other hospitals who did not receive PEP.
Six workers (14%) developed MERS-CoV infection; all of these subjects belonged to the non-PEP group. The attack rate was lower in the PEP group compared with the non-PEP group (0% vs. 28.6%; Odds ratio = 0.405, 95% confidence interval = 0.274–0.599;
PEP with a combination of oral ribavirin and lopinavir/ritonavir appears to be effective and generally safe for preventing MERS-CoV infection after high-risk exposure in healthcare workers.
Url:
DOI: 10.1093/ofid/ofy210.2143
PubMed: NONE
PubMed Central: 6255574
Affiliations:
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Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers</title><author><name sortKey="Park, So Yeon" sort="Park, So Yeon" uniqKey="Park S" first="So Yeon" last="Park">So Yeon Park</name><affiliation><nlm:aff id="AF0001">Infectious Diseases, Kangdong Sacred Heart Hospital Hallym University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Jin Seo" sort="Lee, Jin Seo" uniqKey="Lee J" first="Jin Seo" last="Lee">Jin Seo Lee</name><affiliation><nlm:aff id="AF0002">Kangdong Sacred Heart Hospital, Hallym medical school, SEOUL, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Kim, Jungok" sort="Kim, Jungok" uniqKey="Kim J" first="Jungok" last="Kim">Jungok Kim</name><affiliation><nlm:aff id="AF0003">Chungnam National University Hospital, Daejeon, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Joo, Eun Jeong" sort="Joo, Eun Jeong" uniqKey="Joo E" first="Eun-Jeong" last="Joo">Eun-Jeong Joo</name><affiliation><nlm:aff id="AF0004">Division of Infectious Diseases, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Eom, Joong Sik" sort="Eom, Joong Sik" uniqKey="Eom J" first="Joong Sik" last="Eom">Joong Sik Eom</name><affiliation><nlm:aff id="AF0005">Infectious Diseases, Gachon University Gil Medical Center, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name><affiliation><nlm:aff id="AF0006">Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">6255574</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255574</idno><idno type="RBID">PMC:6255574</idno><idno type="doi">10.1093/ofid/ofy210.2143</idno><idno type="pmid">NONE</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">000634</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000634</idno><idno type="wicri:Area/Pmc/Curation">000634</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000634</idno><idno type="wicri:Area/Pmc/Checkpoint">000664</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000664</idno><idno type="wicri:Area/Ncbi/Merge">002B61</idno><idno type="wicri:Area/Ncbi/Curation">002B61</idno><idno type="wicri:Area/Ncbi/Checkpoint">002B61</idno><idno type="wicri:Area/Main/Merge">000B05</idno><idno type="wicri:Area/Main/Curation">000B02</idno><idno type="wicri:Area/Main/Exploration">000B02</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">2491. Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers</title><author><name sortKey="Park, So Yeon" sort="Park, So Yeon" uniqKey="Park S" first="So Yeon" last="Park">So Yeon Park</name><affiliation><nlm:aff id="AF0001">Infectious Diseases, Kangdong Sacred Heart Hospital Hallym University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Jin Seo" sort="Lee, Jin Seo" uniqKey="Lee J" first="Jin Seo" last="Lee">Jin Seo Lee</name><affiliation><nlm:aff id="AF0002">Kangdong Sacred Heart Hospital, Hallym medical school, SEOUL, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Kim, Jungok" sort="Kim, Jungok" uniqKey="Kim J" first="Jungok" last="Kim">Jungok Kim</name><affiliation><nlm:aff id="AF0003">Chungnam National University Hospital, Daejeon, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Joo, Eun Jeong" sort="Joo, Eun Jeong" uniqKey="Joo E" first="Eun-Jeong" last="Joo">Eun-Jeong Joo</name><affiliation><nlm:aff id="AF0004">Division of Infectious Diseases, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Eom, Joong Sik" sort="Eom, Joong Sik" uniqKey="Eom J" first="Joong Sik" last="Eom">Joong Sik Eom</name><affiliation><nlm:aff id="AF0005">Infectious Diseases, Gachon University Gil Medical Center, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author><author><name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name><affiliation><nlm:aff id="AF0006">Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)</nlm:aff><wicri:noCountry code="subfield">Republic of (South)</wicri:noCountry></affiliation></author></analytic><series><title level="j">Open Forum Infectious Diseases</title><idno type="eISSN">2328-8957</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="s1"><title>Background</title><p>In 2015, an outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection occurred in South Korea involving 186 patients, 39 of whom were healthcare workers (HCWs) exposed to the infection. An effective post-exposure prophylaxis (PEP) strategy may limit the spread of infection; however, there is no consensus regarding PEP for MERS-CoV infection. In this study, we assessed (1) the efficacy of oral ribavirin and lopinavir/ritonavir as PEP for HCWs exposed to patients with severe MERS-CoV pre-isolation pneumonia, and (2) safety of the PEP regimen.</p></sec><sec id="s2"><title>Methods</title><p>We retrospectively enrolled 43 HCWs with high-risk exposure to MERS-CoV from 5 hospitals affected during this outbreak in South Korea. The rate of MERS-CoV infection was compared between 22 workers at 1 hospital who received PEP consisting of oral ribavirin and lopinavir/ritonavir after exposure to patients with severe MERS-CoV pre-isolation pneumonia and 21 workers at other hospitals who did not receive PEP.</p></sec><sec id="s3"><title>Results</title><p>Six workers (14%) developed MERS-CoV infection; all of these subjects belonged to the non-PEP group. The attack rate was lower in the PEP group compared with the non-PEP group (0% vs. 28.6%; Odds ratio = 0.405, 95% confidence interval = 0.274–0.599; <italic>P</italic> = 0.009). The most commonly reported side effects of PEP therapy were nausea and diarrhea, but there were no severe adverse effects associated with PEP therapy.</p></sec><sec id="s4"><title>Conclusion</title><p>PEP with a combination of oral ribavirin and lopinavir/ritonavir appears to be effective and generally safe for preventing MERS-CoV infection after high-risk exposure in healthcare workers.</p></sec><sec id="s5"><title>Disclosures</title><p><bold>All authors:</bold> No reported disclosures.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Eom, Joong Sik" sort="Eom, Joong Sik" uniqKey="Eom J" first="Joong Sik" last="Eom">Joong Sik Eom</name><name sortKey="Joo, Eun Jeong" sort="Joo, Eun Jeong" uniqKey="Joo E" first="Eun-Jeong" last="Joo">Eun-Jeong Joo</name><name sortKey="Kim, Jungok" sort="Kim, Jungok" uniqKey="Kim J" first="Jungok" last="Kim">Jungok Kim</name><name sortKey="Lee, Jin Seo" sort="Lee, Jin Seo" uniqKey="Lee J" first="Jin Seo" last="Lee">Jin Seo Lee</name><name sortKey="Park, So Yeon" sort="Park, So Yeon" uniqKey="Park S" first="So Yeon" last="Park">So Yeon Park</name><name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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