Adjuvant Immunosuppression in the Management of Severe Influenza

Ison, Michael G.

doi:10.1097/ccm.0b013e3182a63779

Cited by 9 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These pro-inflammatory cytokines/chemokines have been observed to correlate clinically with severity, as well as outcomes of influenza, i.e. fever, symptoms scores, tachypnea, hypoxemia, pneumonia extent, length-of-stay and, ICU admission/death, representing their pathogenic roles [32,50,[54][55][56][57]. In this study, significant trends toward faster symptom resolution were observed with Oseltamivir and AZM combination therapy.…”

Section: Discussionmentioning

confidence: 56%

Assessment of efficacy of Oseltamivir-Azithromycin combination therapy in prevention of Influenza-A (H1N1)pdm09 infection complications and rapidity of symptoms relief

Ishaqui

Khan

Sulaiman

et al. 2020

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

Objectives: This study aimed to assess the efficacy of oseltamivir-Azithromycin combination therapy for prevention of Influenza-A (H1N1)pdm09 infection associated complications and early relief of influenza symptoms. Methods: In a retrospective observational cohort study, Influenza-A (H1N1)pdm09 infection hospitalized patients were identified and divided into two groups based on the initial therapy. Group-AV patients were initiated on Oseltamivir without any antibiotic in treatment regimen while Group-AV+AZ patients were initiated on Oseltamivir and Azithromycin combination therapy for at least 3-5 days. Patients were evaluated for different clinical outcomes. Results: A total of 227 and 102 patients were identified for Group-AV and Group-AV+AZ respectively. Multivariate regression analysis showed that incidences of secondary bacterial infections were significantly less frequent (23.4% vs 10.4%; P-value = 0.019) in Group-AV+AZ patients. Group-AV+AZ patients were associated with shorter length of hospitalization (6.58 vs 5.09 days; P-value = <0.0001) and less frequent incidences of respiratory support (38.3% vs 17.6%; P-value = 0.016). Overall influenza symptom severity score was statistically significant less for Group-AV+AZ patients on Day-5 (10.68 ± 2.09; P-value = 0.001) of hospitalization. Conclusion: Oseltamivir-Azithromycin combination therapy was found to be more efficacious as compared to oseltamivir alone in rapid recovery and prevention of Influenza associated complications especially in high risk patients.

show abstract

Section: Discussionmentioning

confidence: 56%

Assessment of efficacy of Oseltamivir-Azithromycin combination therapy in prevention of Influenza-A (H1N1)pdm09 infection complications and rapidity of symptoms relief

Ishaqui

Khan

Sulaiman

et al. 2020

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…Nonetheless, more data from animal and human studies of severe influenza infection are clearly needed before a rapamycin inhibitor (sirolimus or everolimus) can be recommended for the treatment of patients with severe influenza. [59]…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Concomitant severe influenza and cryptococcal infections

Huang¹,

Li²,

Lan³

et al. 2019

Medicine

View full text Add to dashboard Cite

Concomitant influenza and cryptococcal infections are rare. Herein, we describe an unusual case of an avian influenza A (H7N9) infection with several severe mixed bacterial infections and systemic super-infection with Cryptococcus neoformans presenting as ventilator-associated pneumonia (VAP) and bloodstream infection in a previously immunocompetent man during hospitalization. A 58-year-old man was admitted to our hospital complaining of hyperpyrexia, dyspnoea, cough, and phlegm with blood. A chest computed tomography scan revealed multiple ground-glass opacities and consolidation in both lungs with right pleural effusion. An initial sputum test was positive for influenza A (H7N9) virus. After antiviral treatment and other supportive measures, the patient's condition improved. However, the patient's condition deteriorated again approximately 2 weeks after admission, and bronchoalveolar lavage fluid (BALF) and blood cultures were positive for C. neoformans . Therapy with intravenous liposomal amphotericin B and fluconazole was started. After a 2-week antifungal treatment, BALF and blood cultures were negative for C. neoformans . However, the patient had persistent lung infiltrates with severe pulmonary fibrosis with a prolonged course of disease. On hospital day 40, BALF and blood cultures were both positive for multidrug-resistant Stenotrophomonas maltophilia . Finally, the patient developed septic shock, disseminated intravascular coagulation and multi-organ failure and succumbed to treatment failure. Cryptococcal infection can occur in patients with severe influenza during hospitalization with a more severe condition, and the clinician should be aware of this infection.

show abstract

“…In human studies, the treatment of severe H1N1 influenza-related pneumonia with rapamycin and steroids was shown to improve the outcome (9,10). However, other researchers have demonstrated that immune suppression caused by systemic steroids, and possibly rapamycin as well, is associated with an increased morbidity/mortality and a prolonged viral replication (11).…”

Section: Mtor and Influenzamentioning

confidence: 99%

Inhaled biguanides and mTOR inhibition for influenza and coronavirus (Review)

Lehrer¹

2020

World Acad Sci J

View full text Add to dashboard Cite

Adjuvant Immunosuppression in the Management of Severe Influenza

Cited by 9 publications

References 21 publications

Assessment of efficacy of Oseltamivir-Azithromycin combination therapy in prevention of Influenza-A (H1N1)pdm09 infection complications and rapidity of symptoms relief

Assessment of efficacy of Oseltamivir-Azithromycin combination therapy in prevention of Influenza-A (H1N1)pdm09 infection complications and rapidity of symptoms relief

Concomitant severe influenza and cryptococcal infections

Inhaled biguanides and mTOR inhibition for influenza and coronavirus (Review)

Contact Info

Product

Resources

About