Journal Article

Lower Clinical Effectiveness of Oseltamivir against Influenza B Contrasted with Influenza A Infection in Children

Norio Sugaya, Keiko Mitamura, Masahiko Yamazaki, Daisuke Tamura, Masataka Ichikawa, Kazuhiro Kimura, Chiharu Kawakami, Maki Kiso, Mutsumi Ito, Shuji Hatakeyama and Yoshihiro Kawaoka

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 44, issue 2, pages 197-202
Published in print January 2007 | ISSN: 1058-4838
Published online January 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/509925
Lower Clinical Effectiveness of Oseltamivir against Influenza B Contrasted with Influenza A Infection in Children

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Background. Recently, many Japanese physicians have claimed that oseltamivir is less effective in children with influenza B virus infection. This study assesses the effectiveness of oseltamivir against influenza A (H3N2) and influenza B in children on the basis of the duration of febrile illness.

Methods. We used oseltamivir to treat 127 children with influenza A (H3N2; mean age, 6.97 years [range, 1–15 years]) and 362 children with influenza B (mean age, 5.16 years [range, 1–15 years]) in outpatient clinics. The duration of fever after the start of oseltamivir therapy was compared in the influenza A group and the influenza B group.

Results. The mean duration of fever after the start of oseltamivir therapy was significantly greater in the influenza B group than in the influenza A (H3N2) group (2.18 days vs. 1.31 days, respectively; P < .001). The difference was marked in young children (1–5 years old; 2.37 days for the influenza B group vs. 1.42 days for the influenza A group) but was not significant among older children (11–15 years old). The 50% inhibitory concentration of oseltamivir against influenza B virus was 75.4 ± 41.7 nmol/L and was substantially higher than that for type A (H3N2) virus (0.3 ± 0.1 nmol/L). Only 3 (1.6%) of 192 influenza B viruses were resistant to oseltamivir.

Conclusions. Oseltamivir is much less effective against influenza B virus infection in young children, probably because of the low sensitivity of influenza B viruses to oseltamivir. The effectiveness of oseltamivir against influenza B is influenced by age and host immunity. A few oseltamivir-resistant influenza B strains were isolated before the start of oseltamivir therapy.

Journal Article.  4230 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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