Klinikum Worms, Klinik für Kinder-und Jugendmedizin, Worms, Germany.
Pediatr Infect Dis J. 2010 Jun;29(6):495-8. doi: 10.1097/INF.0b013e3181cc4d01.
Influenza causes proportionately more hospitalizations and deaths in infants in their first year of life than in older children. Oseltamivir is an effective treatment for childhood influenza, but few data are available in infants <1 year.
Medical records of infants <1 year admitted to hospital during the influenza seasons 2003-2007 were retrospectively analyzed to evaluate clinical presentation, and safety and outcome with oseltamivir therapy. Eligible infants were those with fever (>38 degrees C), influenza-like symptoms of sudden onset, positive rapid influenza test and parental consent, who received oseltamivir within 48 hours of the start of symptoms. Infants vaccinated against influenza or receiving immunosuppressants were excluded.
In 157 evaluable infants (mean age 6.3 [SD 3.2] months; 86 boys), the most common presenting symptoms other than fever were rhinitis, pharyngitis, cough, feeding difficulties, and otitis media. During treatment, additional symptoms were observed in 78 (50%) infants; most of these were gastrointestinal (vomiting and diarrhea) and of mild intensity. Fever resolved in 128 (82%) infants within 36 hours of starting oseltamivir (136 [87%] within 48 hours). Complications were recorded in 84 patients (54%), the most serious of which were meningitis in 1 infant (1%), pneumonia in 9 (6%), and otitis media in 2 (1%). Twenty infants received antibiotics for secondary infections (10 [6%] before admission).
The clinical presentation of influenza and outcome of oseltamivir treatment in infants <1 year was similar to that previously reported in older children, but mild gastrointestinal symptoms were common.
流感在一岁以下婴儿中的住院率和死亡率均高于较大儿童。奥司他韦是治疗儿童流感的有效药物，但在一岁以下婴儿中可用的数据很少。
回顾性分析了 2003-2007 年流感季节期间住院的一岁以下婴儿的病历，以评估其临床表现以及接受奥司他韦治疗的安全性和结局。符合条件的婴儿是指那些有发热（>38°C）、突发流感样症状、快速流感检测阳性且父母同意、在症状开始后 48 小时内接受奥司他韦治疗的婴儿。排除了接种流感疫苗或接受免疫抑制剂治疗的婴儿。
在 157 名可评估的婴儿（平均年龄 6.3 [SD 3.2] 个月；86 名男孩）中，除发热外，最常见的其他表现症状为鼻炎、咽炎、咳嗽、喂养困难和中耳炎。在治疗过程中，78 名（50%）婴儿出现了其他症状；这些症状大多为胃肠道（呕吐和腹泻），且症状轻微。128 名（82%）婴儿在开始使用奥司他韦后 36 小时内（136 名[87%]在 48 小时内）体温恢复正常。84 名患者（54%）记录到并发症，其中最严重的并发症为 1 名婴儿（1%）脑膜炎、9 名（6%）肺炎和 2 名（1%）中耳炎。20 名婴儿因继发感染接受了抗生素治疗（入院前 10 名[6%]）。
一岁以下婴儿流感的临床表现和奥司他韦治疗结局与之前在较大儿童中报告的情况相似，但常见轻微的胃肠道症状。
