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季节性流感的管理:印度尼西亚的奥司他韦治疗政策?

Managing seasonal influenza: oseltamivir treatment policy in indonesia?

作者信息

Kosasih Herman, Bratasena Arie, Pangesti Krisna, Laras Kanti, Samaan Gina

机构信息

INA-RESPOND Secretariat, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2014 Jan;46(1):58-65.

Abstract

To manage cases of avian influenza A/H5N1 virus infection and in anticipation of a pandemic triggered by this virus, Indonesia purchased and distributed oseltamivir to the government health facilities. Oseltamivir is an antiviral drug that was developed for the treatment of influenza infections. Disease surveillance and research suggests that seasonal influenza (A/H1N1, A/H3N2 or B) results in considerable morbidity and mortality in Indonesia, where over 15% of influenza-like illness and severe acute respiratory illness patients test positive for the influenza virus. Indonesia currently limits oseltamivir for the management of avian influenza A/H5N1cases and in anticipation of a pandemic triggered by the A/H5N1 virus. We present the evidence for the use of oseltamivir in the treatment of seasonal influenza infections so that doctors have the option to prescribe the drug. We propose that the benefits of this approach will largely outweigh the risk of antiviral resistance. We recommend that oseltamivir be available for administration to patients with seasonal influenza infections, especially for those hospitalized and for groups with high risk of complications and adverse outcomes. Overall, this will reduce morbidity and mortality of seasonal influenza.

摘要

为应对甲型H5N1禽流感病毒感染病例,并预期该病毒引发大流行,印度尼西亚采购了磷酸奥司他韦并分发给政府卫生机构。磷酸奥司他韦是一种开发用于治疗流感感染的抗病毒药物。疾病监测和研究表明,季节性流感(甲型H1N1、甲型H3N2或乙型)在印度尼西亚导致了相当高的发病率和死亡率,该国超过15%的流感样疾病和严重急性呼吸道疾病患者流感病毒检测呈阳性。印度尼西亚目前将磷酸奥司他韦的使用限制在甲型H5N1禽流感病例的管理以及预期由H5N1病毒引发的大流行方面。我们提供了使用磷酸奥司他韦治疗季节性流感感染的证据,以便医生能够选择开具该药物。我们认为这种方法的益处将在很大程度上超过抗病毒耐药性的风险。我们建议应为季节性流感感染患者提供磷酸奥司他韦,特别是对于那些住院患者以及有并发症和不良后果高风险的人群。总体而言,这将降低季节性流感的发病率和死亡率。

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