Neuroaminidase inhibitors improve survival for children with influenza if prescribed within 48 hours of onset of illness - these test results were published in the November issue of Pediatrics .

It has been shown that the earliest possible appointment of neuroamine amidase inhibitors in children with influenza hospitalized in the ICU can improve survival, including patients with the most severe course of the disease. require mechanical ventilation.

Currently, both worldwide and in USA, oseltamivir is used orally, zanamivir is inhaled as a neuroaminidase inhibitor, and intravenous preparations of peramivir and zanamivir are in clinical trials.

The researchers examined medical data from 784 children aged 0 to 18 who were hospitalized in the ICU during the H1N1 pandemic in 2009 (591 cases from April 3, 2009 to August 31, 2010) and in the post-pandemic period. Neuroaminidase inhibitors were prescribed to 532 patients (90%) during the pandemic and only 63% (121 children) in the post-pandemic period (p less than 0.0001).

Out of 653 children receiving neuroaminidase inhibitors, 38 people (6%) died, compared to 11 out of 131 (8%) who did not receive neuroaminidase inhibitors (odds ratio 0.67, confidence interval at 95% 0.34-1.36).

In a bivariate analysis, in which patients were stratified by mechanical ventilation, it was found that treatment with neuroaminidase inhibitors led to a significant reduction in mortality (odds ratio 0.38, 95% CI 0, 17-0.87), however, similar results were not obtained during the stratification of patients' pneumonia (odds ratio 0.64, 95% CI 0.29-1.38).

In a multivariate analysis, it was found that concomitant diseases, the diagnosis of pneumonia and the need for mechanical ventilation were variables that significantly increased the risk of death.

The calculated risk of death was reduced with the appointment of neuroaminidase inhibitors (odds ratio 0.36, 95% CI 0.16-0.84). The survival rate of children for whom neuroaminidase inhibitors were prescribed during the first 48 hours of the disease was statistically significantly higher (p = 0.04).

There were statistically significant differences between the mean time between the onset of symptoms and the start of treatment when analyzing non-fatal cases of the disease (on average, 3 days, 0 to 33 days) compared to disease ending in death (5 days, 0 to 29 days, p = 0.004).

Thus, the earliest possible initiation of treatment with neuroaminidase inhibitors is considered to be an appropriate approach in patients with ICU, that is to say with severe influenza and a high probability of death.