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Oseltamivir efficacy, side effects, and safety in children with influenza

Korean Journal of Pediatrics 2010;53(1):56-66.
Published online January 15, 2010.
Oseltamivir efficacy, side effects, and safety in children with influenza
Eun Sun Seo1, Geun Hwa Park1, Sung Won Kim1, Sung Won Kim1, Woo Sik Jung1, Kyung Soon Cho2, Yeon Gyeong Park2, Chang Kyu Lee3, Chun Kang4, Joo Yeon Lee4, Woo Young Choi4
1Department of Pediatics, Busan St. Mary`s Medical Center, Korea
2Institute of Health & Environment, Busan, Korea
3Department of Laboratory Medicine†, Anam Hospital of Korea University Medical Center, Korea
4Department of Influenza, Centers for Disease Control and Prevention, Korea
인플루엔자 바이러스 감염 소아 환아에서 Oseltamivir 약제 효용성과 단기간ㆍ장기간 부작용 및 안전성에 관한 임상연구
서은선1, 박근화1, 김성미1, 김성원1, 정우식1, 조경순2, 박연경2, 이창규3, 강춘4, 이주연4, 최우영4
1부산 성모병원 소아청소년과
2부산광역시 보건 환경 연구원
3고려대학교 부속 안암병원 진단검사의학과
4질병관리본부 국립보건연구원 인플루엔자 바이러스팀
Correspondence: 
Sung Won Kim, Tel: +82.51-933-7984, Fax: +82.51-936-7531, Email: Sung Mi Kim, M.D.
Abstract
Purpose
: Although oseltamivir is widely used for treatment of influenza, few clinical studies of its efficacy and resistance have been performed in Korea. We evaluated the safety, side effects, and efficacy of oseltamivir treatment in Korean pediatric patients.
Methods
: We analyzed 321 children diagnosed with influenza at Busan St. Mary's Medical Center, Korea, between January 2008 and June 2008 (first study period) and November 2008 and January 2009 (second study period). Patients were divided into two groups: those receiving oseltamivir treatment for 5 days and those receiving only symptomatic treatment. We investigated clinical symptoms, side effects, and resistance to oseltamivir. We also identified influenza strains and evaluated resistance to oseltamivir using an influenza virus culture.
Results
: One hundred eighty-six patients were assigned to the treatment group, and 135 were assigned to the control group. The treatment group showed shorter admission duration (4.4 days) compared with controls (5.0 days) (P=0.000) and had fewer lower respiratory tract complications compared with controls (P<0.05). No significant statistical difference in the virus antigenic type was observed between the groups. In the first study period, virus culture showed influenza B (41.7% vs. 49.6%), A/H3N2 (7.9% vs. 8.4%), and A/H1N1 (9.4% vs. 6.5%). In the second study period, only A/H1N1 (55.3% vs. 50.0%) was isolated, except for one case of A (H3N2) in the treatment group. No differences in short- and long-term side effects, including neuropsychologic side effects, were noted between groups. There was no resistance to oseltamivir before or after treatment in the first study period.
Conclusion
: Based on our results, we suggest that osetalmivir therapy in pediatric patients is effective.
Key Words: Influenza, Oseltamivir, Efficacy, Resistance


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