1. Duration of fever in children infected with influenza A(H1N1)pdm09, A(H3N2) or B virus and treated with baloxavir marboxil, oseltamivir, laninamivir, or zanamivir in Japan during the 2012-2013 and 2019-2020 influenza seasons.
- Author
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Sun Y, Wagatsuma K, Saito R, Sato I, Kawashima T, Saito T, Shimada Y, Ono Y, Kakuya F, Minato M, Kodo N, Suzuki E, Kitano A, Chon I, Phyu WW, Li J, and Watanabe H
- Subjects
- Humans, Child, Japan, Female, Male, Child, Preschool, Adolescent, Infant, Seasons, Thiepins therapeutic use, Thiepins pharmacology, Oxazines therapeutic use, Time Factors, Benzoxazines therapeutic use, Influenza, Human drug therapy, Influenza, Human virology, Antiviral Agents therapeutic use, Antiviral Agents pharmacology, Influenza B virus drug effects, Influenza B virus genetics, Zanamivir therapeutic use, Zanamivir analogs & derivatives, Zanamivir pharmacology, Triazines therapeutic use, Triazines pharmacology, Guanidines therapeutic use, Influenza A Virus, H3N2 Subtype drug effects, Influenza A Virus, H3N2 Subtype genetics, Influenza A Virus, H1N1 Subtype drug effects, Pyridones therapeutic use, Dibenzothiepins therapeutic use, Pyrans, Oseltamivir therapeutic use, Fever drug therapy, Fever virology, Sialic Acids, Morpholines therapeutic use
- Abstract
We compared the duration of fever in children infected with A(H1N1)pdm09, A(H3N2), or influenza B viruses following treatment with baloxavir marboxil (baloxavir) or neuraminidase inhibitors (NAIs) (oseltamivir, zanamivir, or laninamivir). This observational study was conducted at 10 outpatient clinics across 9 prefectures in Japan during the 2012-2013 and 2019-2020 influenza seasons. Patients with influenza rapid antigen test positive were treated with one of four anti-influenza drugs. The type/subtype of influenza viruses were identified from MDCK or MDCK SIAT1 cell-grown samples using two-step real-time PCR. Daily self-reported body temperature after treatment were used to evaluate the duration of fever by treatment group and various underlying factors. Among 1742 patients <19 years old analyzed, 452 (26.0%) were A(H1N1)pdm09, 827 (48.0%) A(H3N2), and 463 (26.0%) influenza B virus infections. Among fours treatment groups, baloxavir showed a shorter median duration of fever compared to oseltamivir in univariate analysis for A(H1N1)pdm09 virus infections (baloxavir, 22.0 h versus oseltamivir, 26.7 h, P < 0.05; laninamivir, 25.5 h, and zanamivir, 25.0 h). However, this difference was not significant in multivariable analyses. For A(H3N2) virus infections, there were no statistically significant differences observed (20.3, 21.0, 22.0, and 19.0 h) uni- and multivariable analyses. For influenza B, baloxavir shortened the fever duration by approximately 15 h than NAIs (20.3, 35.0, 34.3, and 34.1 h), as supported by uni- and multivariable analyses. Baloxavir seems to have comparable clinical effectiveness with NAIs on influenza A but can be more effective for treating pediatric influenza B virus infections than NAIs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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