Oseltamivir: pharmacokinetics, clinical efficacy and importance in influenza pandemic

Abstract

Inhibitor neuraminidaze oseltamivir, za peroralnu primjenu, registriran je za liječenje i sprječavanje influence A i B u odraslih i u djece starije od jedne godine. Liječenje i profilaksa moraju se započeti unutar 48 sati od pojave prvih simptoma, odnosno od kontakta s bolesnikom. Oseltamivir (2 × 75 mg, 5 dana) je siguran i učinkovit lijek u liječenju i sprječavanju svih poznatih tipova virusa influence. Ublažuje težinu i skraćuje trajanje simptoma te smanjuje učestalost karakterističnih komplikacija (bronhitis, otitis, pneumonija). Liječenje oseltamivirom također znatno smanjuje uporabu antibiotika, hospitalizaciju bolesnika i stopu smrtnosti. Postekspozicijska profilaktička primjena oseltamivira (1 × 75 mg, 7 dana) imala je 89 %-tnu učinkovitost. Također i sezonska profilaksa u starijih ljudi pruža 92 %-tnu zaštitu. Nalazi brojnih kliničkih istraživanja u cijelom svijetu pokazuju da je oseltamivir vrlo siguran lijek s dobrom podnošljivošću, a samo u vrlo malog broja bolesnika registriraju se blage prolazne probavne smetnje (mučnina, povraćnje). Budući je oseltamivir učinkovit protiv svih virusa influence, Svjetska zdravstvena organizacija je preporučila nabavu i čuvanje oseltamivira za pandemijsku pojavu gripe.Oseltamivir, an orally-administered neuraminidase inhibitor, is licensed for the treatment and prophylaxis of influenza A and B in adults and children aged 1 year or older. Therapy and prophylaxis should begin within 48 hours of exposure. Oseltamivir (75 mg twice daily for 5 days) is safe and effective for the treatment and prevention of all known influenza subtypes, reducing the severity and duration of symptoms, as well as complications arising from influenza infection (bronchitis, otitis media, pneumonia). Treatment with oseltamivir also reduces the frequency of antibiotic use, hospital admission and mortality rate. Postexposure prophylaxis with oseltamivir, 75 mg once daily for 7 days, gave 89 % protection. Similarly, seasonal prophylaxis in elderly people provided 92 % protection. Results of numerous clinical studies around the world indicated that oseltamivir is a very well tolerated drug, with few patients reporting transient, and mostly mild gastrointestinal disturbances (nausea or vomiting). Since oseltamivir has been shown to be effective against pandemic strains of influenza, the World Health Organization has recommended the stockpiling of oseltamivir in the event of an influenza pandemic