Kawai Naoki, Ikematsu Hideyuki, Iwaki Norio, Maeda Tetsunari, Kanazawa Hideo, Kawashima Takashi, Tanaka Osame, Yamauchi Satoshi, Kawamura Kenichi, Nagai Toru, Horii Satsuki, Hirotsu Nobuo, Kashiwagi Seizaburo
Japan Physicians Association, Tokyo Medical Association Building 3F, 2-5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan.
J Infect. 2008 Jan;56(1):51-7. doi: 10.1016/j.jinf.2007.09.002. Epub 2007 Oct 15.
To compare the effectiveness of zanamivir with oseltamivir for influenza A and B.
1113 patients with influenza A or B were enrolled in the 2006-2007 influenza season. The duration of fever (temperature, >or=37.5 degrees C) and the percentage of patients afebrile at 24 and 48 h after the first dose of zanamivir or oseltamivir were calculated. Virus persistence after zanamivir therapy was also evaluated.
There were marginally significant differences between the duration of fever after the first dose of zanamivir (31.8+/-18.4h) and oseltamivir (35.5+/-23.9h) for influenza A (p<0.05). The duration of fever after starting zanamivir therapy (35.8+/-22.4h) was significantly shorter than that of oseltamivir (52.7+/-31.3h) for influenza B (p<0.001). There were no significant differences between influenza A and B in the percentage of patients afebrile at 24 or 48 h after the first inhalation of zanamivir. The reisolation rate after zanamivir therapy showed marginally significant differences between influenza A and B (<0.05). By multiple regression analysis, therapy (zanamivir or oseltamivir) was the major determinant affecting the duration of fever for influenza B.
Zanamivir therapy is more effective than oseltamivir for the treatment of influenza B infection.
比较扎那米韦与奥司他韦治疗甲型和乙型流感的有效性。
在2006 - 2007年流感季节纳入1113例甲型或乙型流感患者。计算首次服用扎那米韦或奥司他韦后发热(体温≥37.5℃)的持续时间以及24小时和48小时后体温恢复正常的患者百分比。还评估了扎那米韦治疗后的病毒持续存在情况。
甲型流感患者首次服用扎那米韦后发热持续时间(31.8±18.4小时)与奥司他韦(35.5±23.9小时)之间存在边缘显著差异(p<0.05)。乙型流感患者开始扎那米韦治疗后的发热持续时间(35.8±22.4小时)显著短于奥司他韦(52.7±31.3小时)(p<0.001)。首次吸入扎那米韦后24小时或48小时体温恢复正常的患者百分比在甲型和乙型流感之间无显著差异。扎那米韦治疗后的病毒重新分离率在甲型和乙型流感之间显示出边缘显著差异(<0.05)。通过多元回归分析,治疗(扎那米韦或奥司他韦)是影响乙型流感发热持续时间的主要决定因素。
扎那米韦治疗乙型流感感染比奥司他韦更有效。