Tracking the next pandemic: Avian Flu Talk |
Tamiflu: Guidance on amount needed |
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Posted: March 27 2006 at 6:46pm |
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The amount of Tamiflu available will depend on, if you use the standard dose. J Infect Dis. 2005 Aug 15;192(4):665-72. Virulence may determine the necessary duration and dosage of oseltamivir treatment for highly pathogenic A/Vietnam/1203/04 influenza virus in mice. Yen HL, Monto AS, Webster RG, Govorkova EA. Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA. BACKGROUND. Control of highly pathogenic avian H5N1 influenza viruses is a major public-health concern. Antiviral drugs could be the only option early in the pandemic. METHODS. BALB/c mice were given oseltamivir (0.1, 1, or 10 mg/kg/day) twice daily by oral gavage; the first dose was given 4 h before inoculation with H5N1 A/Vietnam/1203/04 (VN1203/04) virus. Five- and 8-day regimens were evaluated. RESULTS. Oseltamivir produced a dose-dependent antiviral effect against VN1203/04 in vivo (P<.01). The 5-day regimen at 10 mg/kg/day protected 50% of mice; deaths in this treatment group were delayed and indicated the replication of residual virus after the completion of treatment. Eight-day regimens improved oseltamivir efficacy, and dosages of 1 and 10 mg/kg/day significantly reduced virus titers in organs and provided 60% and 80% survival rates, respectively (P<.05). Overall, the efficacy of the 5- and 8-day regimens differed significantly (death hazard ratio, 2.658; P<.01). The new H5N1 antigenic variant VN1203/04 was more pathogenic in mice than was A/HK/156/97 virus, and a prolonged and higher-dose oseltamivir regimen may be required for the most beneficial antiviral effect. CONCLUSIONS. Oseltamivir prophylaxis is efficacious against lethal challenge with VN1203/04 virus in mice. Viral virulence may affect the antiviral treatment schedule. PMID: 16028136 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16028136&query_hl=7&itool=pubmed_docsum |
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Tamiflu's recommended dosing for the flu is 1 capsule 2 time a day for 5 days. Any one who purchased tamiflu has 1 "dose" which is a total of 10 capsules. This study states that giving the "recommended dose" for five days had a 50% mortality rate. For 8 days 20% mortality rate. This mean that you need a minimum of 16 capsules. Since the virus was still shed after 8 days, I would think that is where they have come up with the 10 day, or doubling the dose for a total of 20 Tamiflu capsules. I must point out that ALL THE MICE DIED that were given NO TAMIFLU!! So it seems that we are going to need much more than we originally thought!! I hope this helps... |
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From Infectious Disease posted above...
[snip]
The new H5N1 antigenic variant VN1203/04 was more pathogenic in mice than was A/HK/156/97 virus, and a prolonged and higher-dose oseltamivir regimen may be required for the most beneficial antiviral effect.
[/snip] From the CIDRAP re-cap.... [snip]
They conclude that it is "encouraging" that the 2004 virus was sensitive to oseltamivir in mice, even though a longer treatment regimen and higher dosage were required. [/snip] It's a puzzle with most of the pieces missing. Like most things that have to do with a potential H5N1 pandemic.... we won't know until we know. SZ
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