Peramivir, an investigational intravenous neuraminidase inhibitor, was given to 31 hospitalized patients with severe viral pneumonia during the 2009 H1N1 influenza pandemic under the Emergency IND regulations. The drug was generally well tolerated and associated with recovery in most patientes.
Background
2009 H1N1 influenza A disproportionately affected pregnant and postpartum women compared to the general population with higher rates of hospitalization and severe illness. The purpose of this study was to examine the use and pharmacokinetics of intravenous peramivir in the treatment of a newly postpartum patient with severe influenza.
Case
A 28-year-old, 37 week pregnant (G4,P3) woman presented to the hospital with severe respiratory symptoms. 2009 H1N1 influenza RT-PCR returned positive and intravenous peramivir was started. She showed rapid improvement and was discharged 29 days following admission.
Conclusion
The pharmacokinetic parameters for this case patient were unexpected based on previously reported pharmacokinetic parameters from phase 1 trials. These differences highlight the need for additional pharmacokinetic reporting of peramivir in pregnant and postpartum patients.
Tetracyclines for tularemia have been associated with higher failure rates. There were 48 cases of tularemia at the University of Missouri between 1988 and 2015. We retrospectively analyzed 17 patients with tularemia who were successfully treated with tetracyclines, and 9 of these patients also underwent aspiration or incision and drainage.
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