Triple-Combination Antiviral Drug for Pandemic H1N1 Influenza Virus Infection in Critically Ill Patients on Mechanical Ventilation

• DOI: 10.1128/aac.05529-11
• Publication Date: 2011-10-04T04:10:31Z
• Authors: Won-Young Kim; Gee Young Suh; Jin Won Huh; Sung-Han Kim; Min-ju Kim; Yun Seong Kim; Hye-Ryoun Kim; Yon Ju Ryu; Min Soo Han; Young Gwan Ko; Gyu Rak Chon; Kwan Ho Lee; Sang-Ho Choi; Sang-Bum Hong
• Keywords: Oseltamivir; Amantadine; Antiviral drug; Combination therapy

A recent in vitro study showed that the three compounds of antiviral drugs with different mechanisms action (amantadine, ribavirin, and oseltamivir) could result synergistic activity against influenza virus. However, no clinical studies have evaluated efficacy safety combination therapy patients severe illness. total 245 adult who were critically ill confirmed pandemic A/H1N1 2009 (pH1N1) virus infection admitted to one intensive care units 28 hospitals Korea reviewed. Patients required ventilator support received either triple-combination drug (TCAD) or oseltamivir monotherapy analyzed. 127 included our analysis. Among them, 24 TCAD therapy, 103 monotherapy. The 14-day mortality was 17% group 35% (P = 0.08), 90-day 46% 59% 0.23). None toxicities attributable occurred study, including hemolytic anemia hepatic related use ribavirin. Logistic regression analysis indicated odds ratio for association 0.58 (95% confidence interval, 0.24 1.42; P 0.24). Although this retrospective did not provide virologic outcomes, results suggest treatment outcome triple amantadine, comparable