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. 2009 Jun 23;6(6):e1000091.
doi: 10.1371/journal.pmed.1000091. Epub 2009 Jun 23.

What is the optimal therapy for patients with H5N1 influenza?

Nicholas J White  1 , Robert G Webster, Elena A Govorkova, Timothy M Uyeki
Affiliations

What is the optimal therapy for patients with H5N1 influenza?

Nicholas J White et al. PLoS Med. .

Abstract

In a 2007 article in PLoS Medicine[10], Holger J. Schünemann and colleagues described a new process used by the World Health Organization for rapidly developing clinical management guidelines in emergency situations. These situations include outbreaks of emerging infectious diseases. The authors discussed how they developed such a "rapid advice" guideline for the pharmacological management of avian influenza A (H5N1) virus infection. The guideline recommends giving the antiviral drug oseltamivir at a dose of 75 mg twice daily for five days. In this Debate, Nicholas White argues that such dosing is inadequate, Robert Webster and Elena Govorkova say that combination antiviral therapy should be used, and Tim Uyeki reminds us that clinical care of patients with H5N1 entails much more than antiviral treatment. These issues may also apply to therapy of patients hospitalized with severe disease due to novel swine-origin influenza A (H1N1) virus infection.

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Conflict of interest statement

NJW is the co-chairman of the World Health Organization antimalarial treatment guidelines committee. RGW reports receiving research funding from Hoffmann-La Roche and BioCryst Pharmaceuticals and receiving consulting fees from GlaxoSmithKline. EAG reports receiving research funding from Hoffmann-La Roche and BioCryst Pharmaceuticals.

Figures

Figure 1
Figure 1. A multidrug approach to the management of influenza.
HA, hemagglutinin; IFN, interferon; LANI, long-acting neuraminidase inhibitor; NA, neuraminidase; siRNA, small interfering RNA.
See this image and copyright information in PMC

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