Montalto N J, Gum K D, Ashley J V
Department of Family Medicine, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston Division, 25301, USA.
Am Fam Physician. 2000 Dec 1;62(11):2467-76.
Influenza causes significant morbidity and mortality and is responsible for considerable medical expenditures. Vaccination is the most effective public health measure to combat this illness. Amantadine and rimantadine are older antiviral agents that have been important adjuncts in the prevention and treatment of influenza A outbreaks. Zanamivir and oseltamivir are newer agents indicated for the treatment of both influenza A and B. For antiviral agents to be effective, they must be used within 48 hours of the onset of influenza symptoms. Antiviral agents reduce the duration of fever and illness by one to two and one-half days and also reduce the severity of some symptoms. Use of amantadine or rimantadine is appropriate if influenza virus A is known to be the predominant agent in a particular year or location. Data need to be evaluated on the development of resistance and use of the newer antiviral agents in geriatric patients, high-risk patients and children. For optimal use of antiviral agents, patients with influenza symptoms must present early, and family physicians must accurately and rapidly diagnose the illness.
流感会导致严重的发病率和死亡率，并造成可观的医疗费用。接种疫苗是对抗这种疾病最有效的公共卫生措施。金刚烷胺和金刚乙胺是较老的抗病毒药物，在预防和治疗甲型流感暴发中一直是重要的辅助药物。扎那米韦和奥司他韦是较新的药物，可用于治疗甲型和乙型流感。抗病毒药物要想有效，必须在流感症状出现后的48小时内使用。抗病毒药物可将发热和患病时间缩短1至2.5天，还能减轻某些症状的严重程度。如果已知甲型流感病毒是某一年或某一地区的主要病原体，使用金刚烷胺或金刚乙胺是合适的。需要评估老年患者、高危患者和儿童中耐药性的发展情况以及新型抗病毒药物的使用情况。为了最佳地使用抗病毒药物，出现流感症状的患者必须尽早就诊，家庭医生必须准确、快速地诊断病情。
