Treatment of Immunocompromised, Critically Ill Patients with Influenza A H1N1 Infection with a Combination of Oseltamivir, Amantadine, and Zanamivir

Case Reports in Infectious Diseases
Wouter J MeijerAnnemarie M J Wensing

Abstract

Immunocompromised patients are at increased risk of complications of influenza virus infection. We report on two critically ill patients on immunosuppressive medication with influenza pneumonia. In both patients, oseltamivir monotherapy did not result in clearance of the virus after 18 and five days, respectively. After adding zanamivir and amantadine to the treatment, PCRs on pharyngeal and/or plasma specimens turned negative in both patients after four and three days, respectively. We suggest, that in critically ill patients with influenza A H1N1 infection, treatment efficacy should be monitored closely and treatment with a combination of antiviral drugs should be considered.

References

Jan 9, 2003·JAMA : the Journal of the American Medical Association·William W ThompsonKeiji Fukuda
Feb 28, 2003·The New England Journal of Medicine·David M WeinstockGianna Zuccotti
Feb 5, 2011·Emerging Infectious Diseases·Samuel B GraitcerAlicia M Fry
Apr 8, 2011·Emerging Infectious Diseases·Christian RenaudJanet A Englund
Oct 5, 2011·Antimicrobial Agents and Chemotherapy·Won-Young KimUNKNOWN Korean Society of Critical Care Medicine H1N1 Collaborative
Mar 27, 2012·The Journal of Infectious Diseases·Alan S PerelsonFrederick G Hayden
Sep 13, 2014·The Lancet Infectious Diseases·Jake DunningUNKNOWN International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC)

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Citations

Mar 25, 2016·Fundamental & Clinical Pharmacology·Jann-Inn TzengChing-Hsia Hung
Sep 7, 2016·American Journal of Ophthalmology·Po Yen LeeShiuh Liang Hsu
Jul 8, 2020·Antimicrobial Agents and Chemotherapy·Bindumadhav M MaratheElena A Govorkova

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Methods Mentioned

BETA
bronchoalveolar lavage
PCR
biopsies
biopsy

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