2491. Post-Exposure Prophylaxis With Ribavirin Plus Lopinavir/Ritonavir for Middle East Respiratory Syndrome in Healthcare Workers
Identifieur interne : 002B61 ( Ncbi/Curation ); précédent : 002B60; suivant : 002B622491. 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
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So Yeon Park<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>
<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>
<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>
<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>
<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>
<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>
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<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>
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