A comparison of the effectiveness of zanamivir and oseltamivir for the treatment of influenza A and B

Kawai, Naoki; Ikematsu, Hideyuki; Iwaki, Norio; Maeda, Tetsunari; Kanazawa, Hideo; Kawashima, Takashi; Tanaka, Osame; Yamauchi, Satoshi; Kawamura, Kenichi; Nagai, Toru; Horii, Satsuki; Hirotsu, Nobuo; Kashiwagi, Seizaburo

doi:10.1016/j.jinf.2007.09.002

« Previous Next »Journal of Infection
Volume 56, Issue 1 , Pages 51-57, January 2008

A comparison of the effectiveness of zanamivir and oseltamivir for the treatment of influenza A and B

Naoki Kawai
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
- Corresponding author. 4–9 Tonomachi, Gifu City 500-8116, Japan. Tel.: +81 58 245 0564; fax: +81 58 246 9057.
- These two authors contributed equally to this work.
Hideyuki Ikematsu
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
- Department of Clinical Research, Hara-doi Hospital, Fukuoka, Japan
- Corresponding author.
- These two authors contributed equally to this work.
Norio Iwaki
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Tetsunari Maeda
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Hideo Kanazawa
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Takashi Kawashima
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Osame Tanaka
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Satoshi Yamauchi
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Kenichi Kawamura
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Toru Nagai
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Satsuki Horii
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Nobuo Hirotsu
- Japan Physicians Association, Tokyo Medical Association Building 3F, 2–5 Kanda-Surugadai, Chiyoda-ku, 101-0062 Tokyo, Japan
Seizaburo Kashiwagi
- Fukuoka Red Cross Blood Center, Fukuoka, Japan

Accepted 6 September 2007. published online 16 October 2007.

Summary

Objective

To compare the effectiveness of zanamivir with oseltamivir for influenza A and B.

Methods

1113 patients with influenza A or B were enrolled in the 2006–2007 influenza season. The duration of fever (temperature, ≧37.5°C) and the percentage of patients afebrile at 24 and 48h after the first dose of zanamivir or oseltamivir were calculated. Virus persistence after zanamivir therapy was also evaluated.

Results

There were marginally significant differences between the duration of fever after the first dose of zanamivir (31.8±18.4h) and oseltamivir (35.5±23.9h) for influenza A (p<0.05). The duration of fever after starting zanamivir therapy (35.8±22.4h) was significantly shorter than that of oseltamivir (52.7±31.3h) for influenza B (p<0.001). There were no significant differences between influenza A and B in the percentage of patients afebrile at 24 or 48h after the first inhalation of zanamivir. The reisolation rate after zanamivir therapy showed marginally significant differences between influenza A and B (<0.05). By multiple regression analysis, therapy (zanamivir or oseltamivir) was the major determinant affecting the duration of fever for influenza B.