A retrospective nationwide study on the use of intravenous (IV) zanamivir in patients receiving intensive care who were pretreated with oseltamivir in the Netherlands was performed. In 6 of 13 patients with a sustained reduction of the viral load, the median time to start IV zanamivir was 9 days (range, 4-11 days) compared with 14 days (range, 6-21 days) in 7 patients without viral load reduction (P = .052). Viral load response did not influence mortality. We conclude that IV zanamivir as late add-on therapy has limited effectiveness. The effect of an immediate start with IV zanamivir monotherapy or in combination with other drugs need to be evaluated.

doi.org/10.1093/infdis/jir397, hdl.handle.net/1765/33307
The Journal of Infectious Diseases
Erasmus MC: University Medical Center Rotterdam

Fraaij, P., van der Vries, E., Beersma, T., Riezebos-Brilman, A., Niesters, B., Eijck, A., de Jong, M., dos Reis Miranda, D., Horrevorts, A. M., Ridwan, B. U., Wolfhagen, M. J. H. M., Houmes, R. J., van Dissel, J., Fouchier, R., Kroes, A., Koopmans, M., D.V.M., Osterhaus, A.& Boucher, C. (2011). Evaluation of the antiviral response to zanamivir administered intravenously for treatment of critically ill patients with pandemic influenza A (H1N1) infection. The Journal of Infectious Diseases, 204(5), 777–782.https://doi.org/10.1093/infdis/jir397