Systemic corticosteroids and early administration of antiviral agents for pneumonia with acute wheezing due to influenza A(H1N1)pdm09 in Japan

Pneumonia patients with wheezing due to influenza A(H1N1)pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1)pdm09 has been controversial. Applicability of systemic corticosteroid...

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Published in:PloS one 2012-02, Vol.7 (2), p.e32280-e32280
Main Authors: Kudo, Koichiro, Takasaki, Jin, Manabe, Toshie, Uryu, Hideko, Yamada, Ritsuko, Kuroda, Emi, Kobayashi, Nobuyuki, Matsushita, Takeji
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Antiviral agents
Antiviral Agents - administration & dosage
Antiviral drugs
Asthma
Biology
Child
Child, Preschool
Corticoids
Corticosteroids
Disease prevention
Drug Administration Schedule
Female
Fever
Hospitalization
Humans
Illnesses
Infant
Infant, Newborn
Infections
Infectious diseases
Influenza
Influenza A
Influenza A Virus, H1N1 Subtype - metabolism
Influenza, Human - drug therapy
Influenza, Human - virology
Laboratories
Male
Males
Medicine
Middle Aged
Morality
Oxygen
Oxygen content
Pandemics
Patients
Pneumonia
Pneumonia - drug therapy
Population studies
Regression Analysis
Respiratory Sounds
Respiratory tract
Respiratory tract diseases
Retrospective Studies
Saturation
Steroids
Swine flu
Viruses
Wheezing
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cited_by cdi_FETCH-LOGICAL-c525t-9b81614c909e5525245aeade43a704c128ff15241c79d7da6be66500c9d407593
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creator Kudo, Koichiro
Takasaki, Jin
Manabe, Toshie
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Yamada, Ritsuko
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Kobayashi, Nobuyuki
Matsushita, Takeji
description Pneumonia patients with wheezing due to influenza A(H1N1)pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1)pdm09 has been controversial. Applicability of systemic corticosteroid treatment needs to be evaluated. We retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1)pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males) was 8 years (range, 0-71). All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0-7). Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6%) and pneumonia with wheezing (43.3%) groups than in the other two groups (p = 0.017). Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group) than in subjects not receiving corticosteroids (no-steroid group) (p
doi_str_mv 10.1371/journal.pone.0032280
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Applicability of systemic corticosteroid treatment needs to be evaluated. We retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1)pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males) was 8 years (range, 0-71). All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0-7). Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6%) and pneumonia with wheezing (43.3%) groups than in the other two groups (p = 0.017). Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group) than in subjects not receiving corticosteroids (no-steroid group) (p&lt;0.001). The steroid group required greater oxygen supply than the no-steroid group (p&lt;0.001). No significant difference was found by the Kaplan-Meier method between the steroid and the no-steroid groups in hours to fever alleviation from the initiation of antiviral agents and hospitalization days. In logistic regression analysis, wheezing, pneumonia and oxygen saturation were independent factors associated with using systemic corticosteroids. Patients with wheezing and a history of asthma were frequently found in the study subjects. Systemic corticosteroids together with early administration of antiviral agents to pneumonia with wheezing and possibly without wheezing did not result in negative clinical outcomes and may prevent progression to severe pneumonia in this study population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22393395</pmid><doi>10.1371/journal.pone.0032280</doi><oa>free_for_read</oa></addata></record>
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source Publicly Available Content (ProQuest); PubMed Central
subjects Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Antiviral agents
Antiviral Agents - administration & dosage
Antiviral drugs
Asthma
Biology
Child
Child, Preschool
Corticoids
Corticosteroids
Disease prevention
Drug Administration Schedule
Female
Fever
Hospitalization
Humans
Illnesses
Infant
Infant, Newborn
Infections
Infectious diseases
Influenza
Influenza A
Influenza A Virus, H1N1 Subtype - metabolism
Influenza, Human - drug therapy
Influenza, Human - virology
Laboratories
Male
Males
Medicine
Middle Aged
Morality
Oxygen
Oxygen content
Pandemics
Patients
Pneumonia
Pneumonia - drug therapy
Population studies
Regression Analysis
Respiratory Sounds
Respiratory tract
Respiratory tract diseases
Retrospective Studies
Saturation
Steroids
Swine flu
Viruses
Wheezing
title Systemic corticosteroids and early administration of antiviral agents for pneumonia with acute wheezing due to influenza A(H1N1)pdm09 in Japan
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