Treatment of Immunocompromised, Critically Ill Patients with Influenza A H1N1 Infection with a Combination of Oseltamivir, Amantadine, and Zanamivir.
Immunocompromised patients are at increased risk of complications of influenza virus infection. We report on two critically ill patients on immunosuppressive medication with influenza pneumonia. In both patients, oseltamivir monotherapy did not result in clearance of the virus after 18 and five days, respectively. After adding zanamivir and amantadine to the treatment, PCRs on pharyngeal and/or plasma specimens turned negative in both patients after four and three days, respectively. We suggest, that in critically ill patients with influenza A H1N1 infection, treatment efficacy should be monitored closely and treatment with a combination of antiviral drugs should be considered.
Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, P.O. Box 85090, Utrecht, Netherlands.
Wouter J
WJ
Meijer
Department of Pharmacy & Pharmacology, Slotervaart Hospital, 1066 EC Amsterdam, Netherlands.
Wiete
W
Kromdijk
Department of Clinical Pharmacy, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
Marcel P H
MP
van den Broek
Department of Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
Pieter-Jan A
PJ
Haas
Department of Hematology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
Monique C
MC
Minnema
Department of Virology, Erasmus Medical Center, 3015 CE Rotterdam, Netherlands.
Charles A
CA
Boucher
Department of Intensive Care, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
Dylan W
DW
de Lange
Department of Virology, Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
Annemarie M J
AM
Wensing