健康成年人的流感抗病毒药物:系统性审查
T Jefferson1, V Demicheli, D Rivetti
1Cochrane Vaccines Field, ASL 20, 15100 Alessandria, Italy. Toj1@aol.com
抗病毒药物阿曼塔丁和里曼塔丁不推用于流感. 神经氨基酶抑制剂对季节性流感的有效性有限,但在流行病中可能有用.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗病毒药物被推用于季节性和流行性流感控制.
- 在自然发生流感的健康成年人中,注册抗病毒药物的疗效,有效性和安全性的证据需要审查.
研究的目的:
- 审查关于注册抗病毒药物的有效性,有效性和安全性的证据,以对抗健康成年人自然发生的流感.
- 评估抗病毒药物的预防和治疗疗效.
主要方法:
- 在2005年10月之前发表的52项随机对照试验 (RCT) 的系统综述和元分析.
- 包括27个预防性和27个治疗性RCT.
- 疗效表达为预防的比例 (1-相对风险) 和治疗中持续结果的平均值或危险比.
主要成果:
- 阿曼塔丁对A型流感有61%的疗效,但引起了显著的不良事件 (恶心,失眠,幻觉).
- 神经氨基酶抑制剂 (oseltamivir,zanamivir) 对症状性流感 (61-62%) 的疗效有限,对无症状病例或类似流感的疾病没有影响.
- 在家庭 (58.5%) 和接触者 (68-89%) 中,奥塞尔塔米维尔显示出暴露后预防的有效性,减少了病毒分泌,并在48小时内开始时预防了下呼吸道并发症.
结论:
- 由于有效性有限和不良反应,应避免使用阿曼塔丁和里曼塔丁.
- 神经氨基酶抑制剂对季节性流感控制的有效性较低.
- 对于严重的流行病或流行病而言,神经氨基酶抑制剂可以与其他公共卫生措施一起考虑.
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