Johnson D C
Department of Pediatrics, Michael Reese Hospital, Chicago, IL 60616.
Postgrad Med. 1988 Feb 1;83(2):136-9, 142-3, 146-8. doi: 10.1080/00325481.1988.11700143.
Progress is being made in the development of drugs for the prevention and treatment of viral respiratory infections. Two drugs currently available to clinicians are amantadine (Symmetral) and ribavirin (Virazole). Oral amantadine is effective for both treatment and prevention of uncomplicated influenza A infections. Although vaccination continues as the mainstay of influenza prevention, amantadine is useful for unvaccinated patients if complications are likely. When used for treatment, it must be started within the first 48 hours of illness. Ribavirin appears to be safe for treatment of respiratory syncytial virus infections in nonintubated infants. It must be delivered by aerosol in a hospital setting. Patients at risk for complications should be given the drug as early as possible in the course of the disease. Efficacy has yet to be proven in intubated patients, but the drug is probably safe to use with proper supervision. On the horizon are rimantadine and the interferons. Rimantadine is similar to amantadine in its action and indications for use and has a lower incidence of side effects. The interferons have not been the hoped-for panacea for viral respiratory infections but may be useful in a nasal spray for the prevention of colds caused by rhinovirus.
在预防和治疗病毒性呼吸道感染的药物研发方面正在取得进展。临床医生目前可用的两种药物是金刚烷胺（Symmetral）和利巴韦林（Virazole）。口服金刚烷胺对治疗和预防单纯性甲型流感感染均有效。尽管接种疫苗仍然是预防流感的主要手段，但如果可能出现并发症，金刚烷胺对未接种疫苗的患者也有用。用于治疗时，必须在发病后的头48小时内开始使用。利巴韦林似乎对治疗未插管婴儿的呼吸道合胞病毒感染是安全的。它必须在医院环境中通过气雾剂给药。有并发症风险的患者应在疾病过程中尽早给予该药物。对于插管患者，其疗效尚未得到证实，但在适当监督下使用该药物可能是安全的。即将出现的药物有金刚乙胺和干扰素。金刚乙胺在作用和使用指征方面与金刚烷胺相似，且副作用发生率较低。干扰素并非人们所期望的治疗病毒性呼吸道感染的万灵药，但可能作为滴鼻剂用于预防由鼻病毒引起的感冒。
