14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 28.008 Session: Influenza Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Intravenous peramivir for treatment of influenza A and B infection in high-risk patients S. Kohno 1 , H. Kida 2 , M. Mizuguchi 3 , N. Hirotsu 4 , T. Ishida 5 , J. Kadota 6 , J. Shimada 7 1 Nagasaki University, Nagasaki, Japan, 2 Hokkaido University, Sapporo, Japan, 3 Tokyo University, Tokyo, Japan, 4 Hirotsu Clinic, Kawasaki, Japan, 5 Kurashiki Central Hospital, Kurashiki, Japan, 6 Oita University, Yufu, Japan, 7 St. Marianna University School of Medicine, Kawasaki, Japan Background: The ongoing pandemic of 2009/H1N1 influenza has increased the awareness of the impact and unpredictable nature of influenza. This in turn has raised the interest in the development of additional drugs to treat the disease when vaccinations fall short. The patient population of most concern are those classified as "high-risk" where influenza causes substantial morbidity and mortality. This high-risk group comprises individuals with underlying chronic disease. In this study, efficacy and safety of intravenous administration of peramivir were evaluated in influenza patients with one or more high-risk co morbidities. Methods: The study was a double-blind, multi-center study of intravenous peramivir with dosing over multiple days. The study enrolled 42 influenza patients with complications due to one or more qualifying conditions: diagnosis with poorly controlled diabetes mellitus, a chronic respiratory disease requiring pharmacotherapy, or current treatment with any immunosuppressive drug. Peramivir was administered at 300 mg or 600 mg per day, and the duration was adjusted (up to five days) on a case-by-case basis, depending on the patient’s temperature and clinical condition as determined by the treating physician. Results: In this study, the median time to alleviation of symptoms in all 37 evaluable patients treated with either 300 mg or 600 mg peramivir daily was 68.6 hrs (90% CI, 41.5 hrs - 113.4 hrs). The median time for each group (300 mg and 600 mg) was 114.4 hrs and 42.3 hrs respectively, while the time for each group categorized as single-dosed (n=10) and multiple-dosed (n=27) was 92.0 hrs and 64.1 hrs, respectively. The incidence of pneumonia, which was the main complication resulting from influenza was 8.1% (3/37). There were no drug-related SAEs throughout the study. Conclusion: The results suggest that intravenous peramivir was effective for treatment of influenza patients with a high-risk for complications co morbidities and increased risk for complications due to influenza infection.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 28.009 Session: Influenza Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Neuraminidase sub typing and drug resistance among influenza A viruses circulating in western India V. Potdar, M. Dakhave, M. Chadha, A. Mishra National Institute of Virology, 421001, India Background: Influenza viruses are important respiratory pathogens in India. Clinical, virological and molecular surveillance is being carried out under a Multi- site Influenza Surveillance project (Indian Council of Medical Research-Centers for Diseases Control). National Institute of Virology, Pune, India monitors genetic variations and drug susceptibility in circulating influenza viruses. Most of the influenza A viruses are amantadine resistance worldwide and hence neuraminidase inhibitors (NAI) oseltamivir or zanamivir are recommended for the treatment of infection with influenza viruses. Methods: Neuraminidase sub typing of 42 H1 and 48 H3 viruses from the year 2003 to April 2009 were carried out by one step diagnostic RT PCR using published primers. Universal M13 primers forward and reverse were used for Sequencing and subtypes of isolates were confirmed by blast analysis. 253 bp product of N1 isolates contains established mutation site H274Y leading to oseltamivir resistance .To check the mutation sites E119V, I222V, R292K, N294S and 244- 247 for N2 isolates; further 1103bp N2 gene was amplified using specific primers. Results: NA Subtyping: 90 influenza A isolates from 2003- April 2009 circulating in Pune were amplified. 90 influenza A isolates were confirmed as 42 N1 and 48 N2 respectively by sequencing. No unusual combinations were observed Detection of drug resistant sites for N1 and N2 isolates: N1 isolates:253 bp amplified product of N1 isolates which included the established mutation site H274Y leading to oseltamivir resistance was analyzed by sequencing. All N1 isolates were sensitive to oseltamivir. N2 isolates: To check the mutation sites for N2 (E119V, I222V, R292K, N294S and 244-247); further 1103 bp products were amplified. All 44 N2 isolates were sensitive to both the drugs oseltamivir and zanamivir. Conclusion: All seasonal influenza A viruses A/H1N1 and A/H3N2 were sensitive to neuraminidase inhibitors. Antiviral drugs against influenza are rarely used in India as a therapeutic agent. However due to globalization, resistant viruses could be seeded in Pune from elsewhere.Though no resistant viruses were detected, continuous surveillance of influenza viruses is needed to monitor circulating strains, and their drug susceptibility in view of pandemic potential of influenza virus.
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