PDF(Pubmed)
Abstract：
Influenza in hospitalized intensive care unit (ICU) patients with respiratory failure is associated with 25% mortality, despite timely oseltamivir treatment. A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy and safety of alternative neuraminidase inhibitor (NAI) regimens compared to standard of care in patients hospitalized for H1N1, H3N2, or B influenza.
The Cochrane collaboration searching methods were followed in Cochrane Library, PubMed, and Web of Science databases (2009-2019). Eligibility criteria were RCTs comparing different regimens of NAIs in hospitalized patients (at least 1 year old) for clinically diagnosed influenza (H1N1, H3N2, or B). Pre-defined endpoints were time to clinical resolution (TTCR), overall mortality, hospital discharge, viral clearance, drug-related adverse events (AEs), and serious adverse events.
Seven trials (1579 patients) were included. Two trials compared two regimens of oral oseltamivir therapy, and one trial compared two regimens of intravenous zanamivir therapy vs oral oseltamivir therapy. Four trials focused on intravenous peramivir therapy: two trials compared two different regimens and two trials compared two different regimens vs oral oseltamivir therapy. Overall, the different regimens were well tolerated, with no significant differences in AEs; nonetheless non-significant differences were reported among different regimens regarding TTCR, mortality, and viral clearance.
Higher compared to standard doses of NAIs or systemic peramivir therapy compared to oral oseltamivir therapy did not demonstrate benefit.
The Cochrane collaboration searching methods were followed in Cochrane Library, PubMed, and Web of Science databases (2009-2019). Eligibility criteria were RCTs comparing different regimens of NAIs in hospitalized patients (at least 1 year old) for clinically diagnosed influenza (H1N1, H3N2, or B). Pre-defined endpoints were time to clinical resolution (TTCR), overall mortality, hospital discharge, viral clearance, drug-related adverse events (AEs), and serious adverse events.
Seven trials (1579 patients) were included. Two trials compared two regimens of oral oseltamivir therapy, and one trial compared two regimens of intravenous zanamivir therapy vs oral oseltamivir therapy. Four trials focused on intravenous peramivir therapy: two trials compared two different regimens and two trials compared two different regimens vs oral oseltamivir therapy. Overall, the different regimens were well tolerated, with no significant differences in AEs; nonetheless non-significant differences were reported among different regimens regarding TTCR, mortality, and viral clearance.
Higher compared to standard doses of NAIs or systemic peramivir therapy compared to oral oseltamivir therapy did not demonstrate benefit.
摘要：
住院重症监护病房（ICU）呼吸衰竭患者的流感与25％的死亡率相关。尽管奥司他韦治疗及时。对随机对照试验（RCT）进行了系统评价，以评估替代神经氨酸酶抑制剂（NAI）方案与标准治疗相比，在H1N1，H3N2或乙型流感住院患者中的疗效和安全性。
Cochrane图书馆遵循了Cochrane协作搜索方法，PubMed,和WebofScience数据库(2009-2019)。合格标准是RCT，比较临床诊断为流感（H1N1，H3N2或B）的住院患者（至少1岁）的不同NAI方案。预定义的终点是临床解决时间（TTCR），总死亡率，医院出院,病毒清除,药物相关不良事件（AE），和严重不良事件。
纳入7项试验（1579例患者）。两项试验比较了两种口服奥司他韦治疗方案，一项试验比较了两种静脉扎那米韦治疗方案与口服奥司他韦治疗方案.四项试验集中于静脉帕拉米韦治疗：两项试验比较了两种不同的方案，两项试验比较了两种不同的方案与口服奥司他韦治疗。总的来说,不同的治疗方案耐受性良好，AEs无显著差异；尽管如此，在TTCR方面，不同方案之间报告无显著差异，死亡率,和病毒清除。
与标准剂量的NAI或全身性帕拉米韦治疗相比，口服奥司他韦治疗没有显示出益处。
Cochrane图书馆遵循了Cochrane协作搜索方法，PubMed,和WebofScience数据库(2009-2019)。合格标准是RCT，比较临床诊断为流感（H1N1，H3N2或B）的住院患者（至少1岁）的不同NAI方案。预定义的终点是临床解决时间（TTCR），总死亡率，医院出院,病毒清除,药物相关不良事件（AE），和严重不良事件。
纳入7项试验（1579例患者）。两项试验比较了两种口服奥司他韦治疗方案，一项试验比较了两种静脉扎那米韦治疗方案与口服奥司他韦治疗方案.四项试验集中于静脉帕拉米韦治疗：两项试验比较了两种不同的方案，两项试验比较了两种不同的方案与口服奥司他韦治疗。总的来说,不同的治疗方案耐受性良好，AEs无显著差异；尽管如此，在TTCR方面，不同方案之间报告无显著差异，死亡率,和病毒清除。
与标准剂量的NAI或全身性帕拉米韦治疗相比，口服奥司他韦治疗没有显示出益处。
