Dreitlein W B, Maratos J, Brocavich J
College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, New York 11439, USA.
Clin Ther. 2001 Mar;23(3):327-55. doi: 10.1016/s0149-2918(01)80042-4.
Influenza infection is responsible for thousands of hospitalizations and deaths in the United States each year. Until recently, management options were limited to vaccination or use of the antiviral agents amantadine and rimantadine. Two antiviral drugs, zanamivir and oseltamivir, have recently been approved by the US Food and Drug Administration for the treatment of influenza A and influenza B.
This article reviews the published data on the pharmacology and clinical utility of zanamivir and oseltamivir in the treatment and prevention of influenza A and influenza B illness.
To identify relevant literature, a search of MEDLINE, International Pharmaceutical Abstracts, and the Iowa Drug Information Service was conducted for the period from 1969 to 2000. The search terms used were influenza, neuraminidase, zanamivir, oseltamivir; amantadine, and rimantadine. The reference lists of the articles so obtained were used to identify additional publications.
Zanamivir and oseltamivir inactivate viral neuraminidase, an enzyme responsible for cleaving sialic acid residues on newly formed virions as they bud off from the host cell. This inhibition results in aggregation of virions on the surface of the host cell, which limits the extent of infection and speeds recovery from illness. Clinical studies have shown that neuraminidase inhibitors can decrease the median duration of influenza-related symptoms by approximately 1 day if initiated within 48 hours of the onset of symptoms of influenza.
Evidence supports the use of zanamivir and oseltamivir in the treatment of influenza; however, additional studies are needed to clarify their utility and tolerability in pediatric and high-risk patients, as well as their utility in the prevention of influenza.
在美国，每年流感感染导致数千人住院和死亡。直到最近，治疗方法还仅限于接种疫苗或使用抗病毒药物金刚烷胺和金刚乙胺。两种抗病毒药物扎那米韦和奥司他韦最近已被美国食品药品监督管理局批准用于治疗甲型和乙型流感。
本文综述已发表的关于扎那米韦和奥司他韦在治疗和预防甲型和乙型流感疾病方面的药理学和临床应用的数据。
为了确定相关文献，检索了1969年至2000年期间的医学文献数据库（MEDLINE）、国际药学文摘和爱荷华药物信息服务。使用的检索词为流感、神经氨酸酶、扎那米韦、奥司他韦、金刚烷胺和金刚乙胺。利用所获得文章的参考文献列表来识别其他出版物。
扎那米韦和奥司他韦可使病毒神经氨酸酶失活，该酶负责在新形成的病毒粒子从宿主细胞芽生时切割唾液酸残基。这种抑制作用导致病毒粒子在宿主细胞表面聚集，从而限制感染程度并加速疾病康复。临床研究表明，如果在流感症状出现后48小时内开始使用，神经氨酸酶抑制剂可使流感相关症状的中位持续时间缩短约1天。
有证据支持使用扎那米韦和奥司他韦治疗流感；然而，需要进一步研究以阐明它们在儿科和高危患者中的效用和耐受性，以及它们在预防流感方面的效用。
