Antiviral Treatment Guidelines for Middle East Respiratory Syndrome
Identifieur interne : 000F11 ( Pmc/Checkpoint ); précédent : 000F10; suivant : 000F12Antiviral Treatment Guidelines for Middle East Respiratory Syndrome
Auteurs : Yong Pil Chong [Corée du Sud] ; Joon Young Song [Corée du Sud] ; Yu Bin Seo [Corée du Sud] ; Jae-Phil Choi [Corée du Sud] ; Hyoung-Shik Shin [Corée du Sud]Source :
- Infection & Chemotherapy [ 2093-2340 ] ; 2015.
Abstract
Middle East respiratory syndrome (MERS) is an acute infectious disease of the respiratory system caused by the new betacoronavirus (MERS coronavirus, MERS-CoV), which shows high mortality rates. The typical symptoms of MERS are fever, cough, and shortness of breath, and it is often accompanied by pneumonia. The MERS-CoV was introduced to Republic of Korea in May 2015 by a patient returning from Saudi Arabia. The disease spread mostly through hospital infections, and by the time the epidemic ended in August, the total number of confirmed diagnoses was 186, among which 36 patients died. Reflecting the latest evidence for antiviral drugs in the treatment of MERS-CoV infection and the experiences of treating MERS patients in Republic of Korea, these guidelines focus on antiviral drugs to achieve effective treatment of MERS-CoV infections.
Url:
DOI: 10.3947/ic.2015.47.3.212
PubMed: 26483999
PubMed Central: 4607778
Affiliations:
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wicri:step="Checkpoint">000F11</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Antiviral Treatment Guidelines for Middle East Respiratory Syndrome</title><author><name sortKey="Chong, Yong Pil" sort="Chong, Yong Pil" uniqKey="Chong Y" first="Yong Pil" last="Chong">Yong Pil Chong</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Song, Joon Young" sort="Song, Joon Young" uniqKey="Song J" first="Joon Young" last="Song">Joon Young Song</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Infectious Diseases, Guro Hospital, Korea University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Infectious Diseases, Guro Hospital, Korea University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Seo, Yu Bin" sort="Seo, Yu Bin" uniqKey="Seo Y" first="Yu Bin" last="Seo">Yu Bin Seo</name><affiliation wicri:level="3"><nlm:aff id="A3">Department of Infectious Diseases, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Infectious Diseases, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Choi, Jae Phil" sort="Choi, Jae Phil" uniqKey="Choi J" first="Jae-Phil" last="Choi">Jae-Phil Choi</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Infectious Diseases, Seoul Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Infectious Diseases, Seoul Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Shin, Hyoung Shik" sort="Shin, Hyoung Shik" uniqKey="Shin H" first="Hyoung-Shik" last="Shin">Hyoung-Shik Shin</name><affiliation wicri:level="3"><nlm:aff id="A5">Center for Infectious Diseases, National Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Center for Infectious Diseases, National Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Infection & Chemotherapy</title><idno type="ISSN">2093-2340</idno><idno type="eISSN">2092-6448</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Middle East respiratory syndrome (MERS) is an acute infectious disease of the respiratory system caused by the new betacoronavirus (MERS coronavirus, MERS-CoV), which shows high mortality rates. The typical symptoms of MERS are fever, cough, and shortness of breath, and it is often accompanied by pneumonia. The MERS-CoV was introduced to Republic of Korea in May 2015 by a patient returning from Saudi Arabia. The disease spread mostly through hospital infections, and by the time the epidemic ended in August, the total number of confirmed diagnoses was 186, among which 36 patients died. Reflecting the latest evidence for antiviral drugs in the treatment of MERS-CoV infection and the experiences of treating MERS patients in Republic of Korea, these guidelines focus on antiviral drugs to achieve effective treatment of MERS-CoV infections.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name></author><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author><author><name sortKey="Perlman, S" uniqKey="Perlman S">S Perlman</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Stockman, Lj" uniqKey="Stockman L">LJ Stockman</name></author><author><name sortKey="Bellamy, R" uniqKey="Bellamy R">R Bellamy</name></author><author><name sortKey="Garner, P" uniqKey="Garner P">P Garner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, As" uniqKey="Omrani A">AS 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Infect Chemother</journal-id><journal-id journal-id-type="iso-abbrev">Infect Chemother</journal-id><journal-id journal-id-type="publisher-id">IC</journal-id><journal-title-group><journal-title>Infection & Chemotherapy</journal-title></journal-title-group><issn pub-type="ppub">2093-2340</issn><issn pub-type="epub">2092-6448</issn><publisher><publisher-name>The Korean Society of Infectious Diseases and Korean Society for Chemotherapy</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26483999</article-id><article-id pub-id-type="pmc">4607778</article-id><article-id pub-id-type="doi">10.3947/ic.2015.47.3.212</article-id><article-categories><subj-group subj-group-type="heading"><subject>Special Article</subject></subj-group></article-categories><title-group><article-title>Antiviral Treatment Guidelines for Middle East Respiratory Syndrome</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chong</surname><given-names>Yong Pil</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Song</surname><given-names>Joon Young</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Seo</surname><given-names>Yu Bin</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Jae-Phil</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Shin</surname><given-names>Hyoung-Shik</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><collab>Rapid Response Team</collab><xref ref-type="author-notes" rid="FN1">*</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.</aff><aff id="A2"><label>2</label>Department of Infectious Diseases, Guro Hospital, Korea University College of Medicine, Seoul, Korea.</aff><aff id="A3"><label>3</label>Department of Infectious Diseases, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.</aff><aff id="A4"><label>4</label>Department of Infectious Diseases, Seoul Medical Center, Seoul, Korea.</aff><aff id="A5"><label>5</label>Center for Infectious Diseases, National Medical Center, Seoul, Korea.</aff><author-notes><corresp>Corresponding Author: Hyoung-Shik Shin, MD, PhD. Director, Center for Infectious Disease, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. Tel: +82-2-2260-7557, Fax: +82-2-2260-0803, <email>hyoungsshin@gmail.com</email></corresp><fn id="FN1" fn-type="other"><p><bold><sup>*</sup>Rapid response team:</bold> Hee Jung Yoon, Jun Yong Choi, Tae Hyong Kim, Young Hwa Choi, Hong Bin Kim, Ji Hyun Yoon, Jacob Lee, Joong Sik Eom, Joon Young Song, Sang-Oh Lee, Won Sup Oh, Hee Jin Cheong, Young Goo Song, Jung Hyun Choi, and Woo Joo Kim.</p></fn></author-notes><pub-date pub-type="ppub"><month>9</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>30</day><month>9</month><year>2015</year></pub-date><volume>47</volume><issue>3</issue><fpage>212</fpage><lpage>222</lpage><history><date date-type="received"><day>31</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>Copyright © 2015 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Middle East respiratory syndrome (MERS) is an acute infectious disease of the respiratory system caused by the new betacoronavirus (MERS coronavirus, MERS-CoV), which shows high mortality rates. The typical symptoms of MERS are fever, cough, and shortness of breath, and it is often accompanied by pneumonia. The MERS-CoV was introduced to Republic of Korea in May 2015 by a patient returning from Saudi Arabia. The disease spread mostly through hospital infections, and by the time the epidemic ended in August, the total number of confirmed diagnoses was 186, among which 36 patients died. Reflecting the latest evidence for antiviral drugs in the treatment of MERS-CoV infection and the experiences of treating MERS patients in Republic of Korea, these guidelines focus on antiviral drugs to achieve effective treatment of MERS-CoV infections.</p></abstract><kwd-group><kwd>MERS</kwd><kwd>Coronavirus</kwd><kwd>Antiviral</kwd><kwd>Treatment</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><title>Recommendation of evidentiary strength and quality</title></caption><alternatives><graphic xlink:href="ic-47-212-i001"></graphic><table frame="hsides" rules="rows"><thead><tr><th valign="top" align="left" rowspan="1" colspan="1">Strength of recommendation</th><th valign="top" align="center" rowspan="1" colspan="1">Quality of evidence for recommendation</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">A: Should always be offered</td><td valign="top" align="left" rowspan="1" colspan="1">I: One or more properly designed randomized, controlled trials</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">B: Should generally be offered</td><td valign="top" align="left" rowspan="1" colspan="1">II: One or more well-designed, nonrandomized trial, cohort, or case-controlled analytical studies (preferably from more than one center), or dramatic results from uncontrolled experiments</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">C: Optional</td><td valign="top" align="left" rowspan="1" colspan="1">III: Expert opinion or descriptive studies</td></tr></tbody></table></alternatives></table-wrap><table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label><caption><title>Antiviral treatment for MERS-CoV</title></caption><alternatives><graphic xlink:href="ic-47-212-i002"></graphic><table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="left" rowspan="1" colspan="1">Medication<sup>a</sup></th><th valign="middle" align="center" rowspan="1" colspan="1">Normal renal function<break></break> (CrCl > 50 mL/min)</th><th valign="middle" align="center" rowspan="1" colspan="1">Impaired renal function<sup>b</sup><break></break> (CrCl 20-50 mL/min)</th><th valign="middle" align="center" rowspan="1" colspan="1">Hemodialysis or CrCl < 20 mL/min</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">A. Ribavirin, high dose<sup>c</sup></td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 1,200 mg po q8h for 4 days<break></break>→ 600 mg po q8h for 4-6 days</td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 600 mg po q8h for 4 days<break></break>→ 200 mg po q8h for 4-6 days</td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 200 mg po q6h for 4 days<break></break>→ 200 mg po q12h for 4-6 days</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"> Ribavirin, alternative intermediate dose<sup>d</sup></td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 10 mg/kg po q8h for 10 days</td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 200 mg po q8h for 10 days</td><td valign="top" align="left" rowspan="1" colspan="1">2,000 mg po loading dose<break></break>→ 200 mg po q12h for 10 days<sup>e</sup></td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">B. Interferon-α2a<sup>f</sup></td><td valign="top" align="left" rowspan="1" colspan="1">180 µg per week for 2 weeks</td><td valign="top" align="left" rowspan="1" colspan="1">Same dose</td><td valign="top" align="left" rowspan="1" colspan="1">Same dose</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">C. Lopinavir/ritonavir<sup>g</sup></td><td valign="top" align="left" rowspan="1" colspan="1">Lopinavir/ritonavir 400 mg/100 mg po q12h for 10 days</td><td valign="top" align="left" rowspan="1" colspan="1">Same dose</td><td valign="top" align="left" rowspan="1" colspan="1">Same dose</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">D. Convalescent plasma</td><td valign="top" align="left" rowspan="1" colspan="1">300-500 mL of full plasma (3-5 mL/kg)</td><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="left" rowspan="1" colspan="1"></td></tr></tbody></table></alternatives><table-wrap-foot><fn><p><sup>a</sup>In the case of adverse effects caused by ribavirin, the dose should be reduced or its use should be suspended.</p><p><sup>b</sup>If continuous renal replacement therapy is being administered, the ribavirin dose should be adjusted according to the plasma removal rate, and when calculation is difficult, consider using a dose that maintains the creatinine clearance rate (CrCl) at 20-50 mL/min.</p><p><sup>c</sup>This is the dose typically used in the treatment of severe acute respiratory syndrome coronavirus or Middle East respiratory syndrome.</p><p><sup>d</sup>This is a reduced dose due to concerns of adverse effects caused by ribavirin, such as cytopenia or hemolytic anemia. Based on the evidence that ribavirin + interferon-α combination therapy shows a synergistic effect <italic>in vitro</italic>, this follows the dose typically used for the treatment of respiratory syncytial virus treatment to ensure safety.</p><p><sup>e</sup>In dialysis patients or those with severe renal dysfunction, use of ribavirin is usually not recommended due to concerns of fatal hemolytic anemia. Therefore, if ribavirin is to be used, the patient should be closely monitored for hemolytic anemia and other major adverse effects.</p><p><sup>f</sup>Pegylated interferon-α2a (Pegasys®; Roche Pharmaceuticals) is administered by subcutaneous injection (SC). It can be replaced by interferon-β1a (Rebif®, 44 µg SC three times per week). Although there have been no clinical trials using interferon-α2b (Pegintron®), its administration can be considered at the treatment dose for hepatitis C, which is 1.5 µg/kg SC once per week.</p><p><sup>g</sup>Lopinavir/ritonavir (Kaletra®) is mostly metabolized by the liver, so care should be taken in patients with severe liver dysfunction.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Chong, Yong Pil" sort="Chong, Yong Pil" uniqKey="Chong Y" first="Yong Pil" last="Chong">Yong Pil Chong</name></region><name sortKey="Choi, Jae Phil" sort="Choi, Jae Phil" uniqKey="Choi J" first="Jae-Phil" last="Choi">Jae-Phil Choi</name><name sortKey="Seo, Yu Bin" sort="Seo, Yu Bin" uniqKey="Seo Y" first="Yu Bin" last="Seo">Yu Bin Seo</name><name sortKey="Shin, Hyoung Shik" sort="Shin, Hyoung Shik" uniqKey="Shin H" first="Hyoung-Shik" last="Shin">Hyoung-Shik Shin</name><name sortKey="Song, Joon Young" sort="Song, Joon Young" uniqKey="Song J" first="Joon Young" last="Song">Joon Young Song</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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