Rimantadine prophylaxis in children: a follow-up study.
In a randomized, double-blind placebo-controlled clinical trial, we evaluated the prophylactic effectiveness of rimantadine in children (ages 1 to 18 years) against infection with influenza A (H3N2) and associated illness and the prevention of transmission of infection to adult members of the child's family. One hundred ten volunteers from 29 families completed this study during a naturally occurring outbreak of influenza A (H3N2). Influenza infections, defined as a positive viral throat culture or a 4-fold increase in antibody titer, occurred in 31.0% of children in the placebo group and 7.4% in the rimantadine group (P = 0.026). Clinical illness with laboratory evidence of influenza infection occurred in 24.1% of children in the placebo group and none in the rimantadine group (P = 0.007). Rimantadine was well-tolerated by the children, with no significant difference in reported adverse effects between the placebo and rimantadine groups. A combined analysis by families of these data and those of our similarly designed 1984 study, revealed that families in whom the children were given rimantadine had a significantly lower rate of influenza A infection and influenza-like illness compared with the families in whom the children were given placebo (68.8% vs. 18.8%, P less than 0.001) and (56.3% vs. 12.5%, P less than 0.001), respectively. We conclude that rimantadine prophylaxis of children appears to be an effective method to prevent influenza A (either H1N1 or H3N2) infection and illness in children.
Crawford
S A
SA
Department of Family Medicine, College of Medicine, University of Oklahoma, Oklahoma City.
Clover
R D
RD
Abell
T D
TD
Ramsey
C N
CN
Glezen
P
P
Couch
R B
RB
D000218:Adamantane / Q000031:analogs & derivatives*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004361:Drug Tolerance; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000235:genetics / Q000517:prevention & control* / Q000635:transmission; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012299:Rimantadine / Q000627:therapeutic use*; D012307:Risk Factors
D012299:Rimantadine; D000218:Adamantane