title: Low dose oral combination chemoprophylaxis with oseltamivir and amantadine for influenza A virus infections in mice.
abstract: In the present study, the effect of combining anti-influenza drugs active at different steps of the influenza virus replication cycle, oseltamivir as a neuraminidase (NA) inhibitor and amantadine targeting M2 protein, was investigated in vivo by oral administration in a mouse model of aerosol influenza virus infection and in vitro in MDCK cells. In mice, doses of oseltamivir and amantadine providing 50-60% survival against A/Hongkong/1/68 (H3N2) or A/PR/8/34 (H1N1) were capable of conferring complete protection when used simultaneously, suggesting that increased inhibition of influenza virus replication by combining oseltamivir and amantadine in vitro translates into protection from lethal infection of mice. The combination of amantadine with oseltamivir required 15-fold less oseltamivir than monotherapy to confer complete protection against lethal aerosol influenza virus infection. Remarkably, amantadine-based combination chemoprophylaxis was even effective against amantadine-resistant A/PR/8/34 influenza virus. Thus, combination chemotherapy may be more efficacious than monotherapy against newly emerging Influenza A subtypes.
authors.affiliation: Robert Koch Institute, Division of Viral Infections, Berlin, Germany. masihik@rki.de
authors.forename: K N
authors.initials: KN
authors.lastname: Masihi
authors.forename: B
authors.initials: B
authors.lastname: Schweiger
authors.forename: T
authors.initials: T
authors.lastname: Finsterbusch
authors.forename: H
authors.initials: H
authors.lastname: Hengel
mesh_terms: D000547:Amantadine / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002460:Cell Line; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects*; D053122:Influenza A Virus, H3N2 Subtype / Q000187:drug effects*; D051379:Mice; D008807:Mice, Inbred BALB C; D009976:Orthomyxoviridae Infections / Q000517:prevention & control*; D053139:Oseltamivir / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D004338:Drug Combinations; D053139:Oseltamivir; D000547:Amantadine