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اخر زيارك لك: 12-09-2016, 11:36 AM الصفحة الرئيسية

مكتبة د/خلف الله مصطفى كروم(ombadda)
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WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza

09-12-2009, 07:36 PM

ombadda
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WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza

    Written by
    Laurie Barclay, MD
    =================================



    August 27, 2009 — The World Health Organization (WHO) has issued guidelines for antiviral treatment of
    novel influenza A (H1N1) and other influenza. The purpose of the new recommendations, which were posted online
    August 20, is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for
    patients presenting with illness caused by influenza virus infection, as well as considerations
    regarding potential use of these antiviral medications for chemoprophylaxis.

    On the basis of a review of data collected with previously circulating strains, and treatment of human
    H5N1 influenza virus infections, the new guidelines expand on recommendations published in May 2009
    , titled "Clinical management of human infection with new influenza A (H1N1) virus: Initial guidance."
    These new guidelines do not change recommendations in the WHO rapid advice guidelines on
    pharmacological management of humans infected with highly pathogenic avian influenza A (H5N1) virus.

    "In April 2009, the [WHO] received reports of sustained person to person infections with [H1N1]
    virus in Mexico and the United States," write Edgar Bautista, from Médico Neumólogo Intensivista, Jefe
    de UCI-INER in Mexico, and colleagues. "Subsequent international spread led WHO to declare on 11 June 2009
    that the first influenza pandemic in 41 years had occurred. This 2009 pandemic H1N1 influenza virus has now spread
    worldwide, with confirmed cases of pandemic H1N1 virus infection reported in more than 100 countries in all 6 WHO regions[, which] has
    led to the need to add to the existing guidance on the use of antivirals."

    The new recommendations highlight oseltamivir and zanamivir, which are neuraminidase inhibitors, and amantadine
    and rimantadine, which are M2 inhibitors. Suggestions are also provided regarding the use of some
    other potential pharmacological treatments, such as ribavirin, interferons, immunoglobulins, and corticosteroids.

    Management of patients with pandemic influenza (H1N1) 2009 virus infection is the primary focus of the statement,
    although it also includes guidance regarding the use of the antivirals for treatment of other seasonal influenza virus
    strains, as well as for infections resulting from novel influenza A virus strains.

    The guidelines urge country and local public health authorities to issue local recommendations for clinicians
    periodically, based on epidemiological and antiviral susceptibility data on the locally circulating influenza
    strains. As the prevalence and severity of the current pandemic evolves, WHO anticipates that additional data
    will be forthcoming that may require revision of the current recommendations. WHO therefore plans to review
    the guidance no later than September 2009 to determine whether modifications to the recommendations are needed

    .
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09-12-2009, 07:41 PM

ombadda
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Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)

    Recommendationsfor chemoprophylaxis of H1N1

    Specific recommendations regarding the use of antivirals for chemoprophylaxis
    of pandemic (H1N1) 2009 influenza virus infection are as follows:
    When risk for human-to-human transmission of influenza is high or low, and the probability of complications
    of infection is high, either because of the influenza strain or because of the baseline risk of the exposed
    group, use of oseltamivir or zanamivir may be considered as postexposure chemoprophylaxis for the affected
    community or group, for individuals in at-risk groups, or for healthcare workers (weak recommendation, moderate-quality evidence).
    Individuals in at-risk groups or healthcare personnel do not need to be offered antiviral chemoprophylaxis if the
    likelihood of complications of infection is low. This recommendation should be applied independent of risk for
    human-to-human transmission (weak recommendation, low-quality evidence).
    For treatment of mild to moderate uncomplicated clinical presentation of infection with multiple cocirculating
    influenza A subtypes or viruses with different antiviral susceptibilities, patients in at-risk groups should be
    treated with zanamivir or oseltamivir plus M2 inhibitor (noting that amantadine should not be used in
    pregnant women). Otherwise-healthy patients with this presentation need not be treated.
    When the clinical presentation of infection with multiple cocirculating influenza A subtypes
    or viruses with different antiviral susceptibilities is severe or progressive,
    all patients should be treated with oseltamivir plus M2 inhibitor, or zanamivir.

    For treatment of mild to moderate uncomplicated clinical presentation of infection with sporadic
    zoonotic influenza A viruses including H5N1, the at-risk population should be treated with
    oseltamivir or zanamivir, and the otherwise-healthy population with oseltamivir.
    All patients, regardless of risk status, with severe or progressive presentation of infection
    with sporadic zoonotic influenza A viruses including H5N1 should be treated with oseltamivir plus an M2 inhibitor.
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09-12-2009, 07:46 PM

Mustafa Mahmoud
<aMustafa Mahmoud
تاريخ التسجيل: 05-16-2006
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Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)



    الجماعة ديل

    ما عندهم مصل مضاد للكوزنة والسرقة بي اسم الدين؟؟؟
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09-12-2009, 07:46 PM

ombadda
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Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)


    Study Highlights
    When antiviral medications for influenza are available, patients with confirmed or strongly suspected infection with influenza pandemic (H1N1) 2009 should be treated as follows:
    All patient groups, including pregnant women, neonates, and young children younger than 5 years, with severe or progressive clinical illness should be treated as soon as possible with oseltamivir (strong recommendation, low-quality evidence).
    Higher doses up to 150 mg twice daily and longer duration of treatment may be needed, depending on clinical response.
    Patients with severe or progressive clinical illness should receive zanamivir when oseltamivir is not available or not possible to use, or when the virus is resistant to oseltamivir but known or likely to be susceptible to zanamivir (strong recommendation, very low-quality evidence).
    Patients considered to be "at risk" are infants and children younger than 5 years, adults older than 65 years, nursing home residents, pregnant women, patients with chronic comorbidities (cardiovascular, respiratory or liver disease, and diabetes), and immunosuppressed patients as a result of malignant disease, HIV infection, or other diseases.
    Patients not in "at-risk" groups with uncomplicated illness because of confirmed or strongly suspected H1N1 infection may not need antiviral treatment (weak recommendation, low-quality evidence).
    Patients in "at-risk" groups with uncomplicated illness because of confirmed or strongly suspected H1N1 infection should be started with oseltamivir or zanamivir treatment as soon as possible after illness onset (strong recommendation, very low-quality evidence).
    Specific recommendations regarding use of antivirals for chemoprophylaxis of pandemic (H1N1) 2009 influenza virus infection are as follows:
    Oseltamivir or zanamivir may be used postexposure as chemoprophylaxis when risk for human-to-human transmission of influenza is high or low, and risk for complications of infection is high, either because of the influenza strain or because of the baseline risk for the exposed group:
    In this setting, oseltamivir or zanamivir may be used in the affected community or group, in individuals in "at-risk" groups, or in healthcare workers (weak recommendation, moderate-quality evidence).
    If the risk for complications of infection is low, individuals in "at-risk" groups or healthcare personnel may not need antiviral chemoprophylaxis, independent of risk for human-to-human transmission (weak recommendation, low-quality evidence).
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09-12-2009, 07:51 PM

ombadda
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Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)

    تنويه:
    هذا المقال المنقول يخاطب:
    for primary care clinicians, infectious disease specialists, public health officials, and other specialists who care for patients with H1N1 and other types of influenza virus infection.
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09-12-2009, 08:16 PM

ombadda
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Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)

    مصطفى محمود
    Quote:
    الجماعة ديل
    ما عندهم مصل مضاد للكوزنة والسرقة بي اسم الدين؟؟؟


    ربنا يشفيك ياخى...
    وببركة العشر الأواخر من هذا الشهر أدعو الله أن يعين عباده المظلومين ويرفع عنهم الظلم





    قول امين
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