Efficacy of Combination Therapy with Oseltamivir Phosphate and Azithromycin for Influenza: A Multicenter, Open-Label, Randomized StudyReport as inadecuate




Efficacy of Combination Therapy with Oseltamivir Phosphate and Azithromycin for Influenza: A Multicenter, Open-Label, Randomized Study - Download this document for free, or read online. Document in PDF available to download.

Background

Macrolides have antibiotic and immunomodulatory activities, which may have a favorable effect on the clinical outcome of patients with infections, including influenza. This study aimed to evaluate the effects of combination therapy with an anti-influenza agent, oseltamivir, and a single-dose formulation of azithromycin AZM, which has been used for influenza-related secondary pneumonia, on influenza patients. The primary endpoint was a change in the expression levels of inflammatory cytokines. Secondary endpoints were the time required for resolution of influenza-related symptoms, incidence of complications, and adverse reactions.

Methods

Patients with seasonal influenza were enrolled in this multicenter, open-label, randomized study. Patients were stratified according to the presence of a high risk factor and were randomized to receive combination therapy with oseltamivir plus an extended-release formulation of AZM combo-group or oseltamivir monotherapy mono-group.

Results

We enrolled 107 patients and randomized them into the mono-group 56 patients or the combo-group 51 patients. All patients were diagnosed with influenza A infection, and none of the patients had comorbid pneumonia. Statistically significant differences were not observed in the expression levels of inflammatory cytokines and chemokines between the 2 groups. The maximum temperature in the combo-group was lower than that in the mono-group on day 3 through day 5 p = 0.048, particularly on day 4 p = 0.037.

Conclusion

To our knowledge, this is the first prospective, randomized, clinical trial of oseltamivir and AZM combination therapy for influenza. Although the difference in inflammatory cytokine expression level was not statistically significant, combination therapy showed an early resolution of some symptoms.

Name of registry

University hospital Medical Information Network UMIN.

Trial Registration no

UMIN000005371



Author: Hiroshi Kakeya , Masafumi Seki , Koichi Izumikawa, Kosuke Kosai, Yoshitomo Morinaga, Shintaro Kurihara, Shigeki Nakamura, Yoshifu

Source: http://plos.srce.hr/



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