- 期刊
住院患者使用Oseltamivir與Peramivir之有效性與安全性
Efficacy and Safety of Oseltamivir and Peramivir in Hospitalized Patients With Influenza
摘要
目的：Oseltamivir和peramivir為治療流行性感冒（簡稱流感）的神經胺酸酶抑制劑（neuraminidase inhibitors, NAIs），peramivir早期為疾病管制署專案採購，提供特殊病患使用，使用經驗有限。因此，本研究的目的為探討因流感的住院病患，使用oseltamivir和peravimir之療效與安全性。方法：回溯性收集2017年間，經流感篩檢確診為A型或B型流感，且收治住院並使用抗流感藥物之成人患者，以病歷回顧方式，記錄患者的臨床表徵與藥物使用劑量、天數。療效以患者的退燒時間（defervescence）為評估指標，定義為有無使用退燒藥物的情況下，病患體溫≤ 37.2°C至少48小時的時間；安全性則記錄使用藥物期間之相關藥物不良反應與併發症。結果：共收納63位患者，其中43位使用oseltamivir、20位為使用peramivir。Peramivir組別的平均退燒時間為27.9小時、oseltamivir組別為34.0小時，前者雖然退燒時間較短，但無統計上的差異。使用oseltamivir和peramivir的患者不良反應發生率分別為11.6和20.0%，所有的副作用皆屬輕微，因此沒有患者因而停止用藥；2組別的死亡率也沒有差異。結論：Oseltamivir與peramivir治療流感的療效相當，若以標準治療劑量用法計算，完成治療的藥費以oseltamivir較低，因此建議可優先選用oseltamivir。但若為高風險族群或口服吸收不佳患者，peramivir為另一用藥選擇，以確保藥物可完全被吸收而發揮抗病毒的效力。
並列摘要
Objective: Oseltamivir and peramivir are neuraminidase inhibitors (NAIs) that are used to treat influenza. However, the difference between the effects of these two drugs remains unclear because peramivir has been used in only a limited number of cases in Taiwan. This study aims to retrospectively assess the efficacy and safety of peramivir and oseltamivir in hospitalized patients with acute influenza infection. Methods: This retrospective study was conducted with hospitalized patients who were diagnosed with type A or type B influenza and treated with either oseltamivir or peramivir during 2017. The data collected were clinical presentation and usage of medication. The efficacy of the drugs was evaluated based on the time to defervescence. Adverse drug reactions (ADRs), complications, and mortality during the treatment were also recorded. Results: Sixty-three patients were enrolled, comprising 43 and 20 patients in the oseltamivir and peramivir groups, respectively. The median time to defervescence was 27.9 and 34.0 h in the peramivir and oseltamivir groups; the difference was not statistically significant. ADRs associated with oseltamivir and peramivir occurred in 11.6 and 20.0% of patients, respectively; however, the severity was mild in all cases. There was no significant difference in mortality between the two groups. Conclusions: Both peramivir and oseltamivir have similar clinical efficacies in treating influenza. Oseltamivir has been suggested as the standard treatment for influenza because of its lower cost. Intravenous administration of peramivir can be another treatment option for patients with serious complications or malabsorption, ensuring complete absorption of the antiviral agent.