TY - JOUR
T1 - Additional treatment with clarithromycin reduces fever duration in patients with influenza
AU - Higashi, Fuyuhiko
AU - Kubo, Hiroshi
AU - Yasuda, Hiroyasu
AU - Nukiwa, Toshihiro
AU - Yamaya, Mutsuo
N1 - Funding Information:
Fuyuhiko Higashi, Horoyasu Yasuda, and Toshihiro Nukiwa have no conflict of interest. Mutsuo Yamaya is a professor and Hiroshi Kubo an associate professor in the Department of Advanced Preventive Medicine for Infectious Disease at Tohoku University Graduate School of Medicine. This department has received funding from 11 pharmaceutical companies: Abbott Japan, Co., Ltd.; Taisho Toyama Pharmaceutical Co., Ltd.; Kyorin Pharmaceutical Co., Ltd.; GlaxoSmithKline K.K.; Daiichi Sankyo Co., Ltd.; Otsuka Pharmaceutical Co., Ltd.; Tanabe Mitsubishi Pharmaceutical Co., Ltd.; Teijin Pharma Co., Ltd.; Ono Yakuhin Co., Ltd.; AstraZeneca K.K. and Nippon Boehringer Ingelheim Co., Ltd.
Funding Information:
This study was supported by Abbott-Japan Co., Ltd. , and Taisho Toyama Pharmaceutical Co., Ltd.
PY - 2014/9
Y1 - 2014/9
N2 - Background: Influenza virus infection-induced inflammatory responses are associated with fever and other symptoms. Although macrolide antibiotics (macrolides) provide anti-inflammatory effects, these effects have not been well studied in influenza patients. Methods: We examined the effects of clarithromycin on influenza symptoms. A randomized, prospective, and open-label study was performed between December 2010 and March 2011 and between December 2012 and March 2013 in patients with pandemic A/H1 2009 influenza or seasonal influenza virus infections. Patients aged >15 years received either neuraminidase inhibitors (control group) or clarithromycin plus neuraminidase inhibitors (clarithromycin group). Body temperature and other symptoms were recorded for 5 days after initiating treatment. Serum interleukin (IL)-6 and IL-8 levels were also measured. Results: Herein, 79 patients were enrolled over the two influenza seasons, and data from 63 patients were analyzed. All patients showed fever and other symptoms, including rhinorrhea (n=38), cough (n=50), sore throat (n=39), arthralgia or myalgia (n=46), and general malaise (n=50). Fever duration was approximately 42% shorter in patients with temperatures ≥38.5 °C (p=0.02), decreasing from 42. h to 24. h. Among patients with pandemic influenza infections (n=20), the rhinorrhea improvement rate was higher in the clarithromycin group (p=0.03; 88% vs. 20%). Serum IL-6 levels decreased 5 days after treatment, but no differences between the two groups were detected. Conclusions: Clarithromycin may have the additional clinical benefit of improving fever, the main symptom of influenza, in patients treated with neuraminidase inhibitors.
AB - Background: Influenza virus infection-induced inflammatory responses are associated with fever and other symptoms. Although macrolide antibiotics (macrolides) provide anti-inflammatory effects, these effects have not been well studied in influenza patients. Methods: We examined the effects of clarithromycin on influenza symptoms. A randomized, prospective, and open-label study was performed between December 2010 and March 2011 and between December 2012 and March 2013 in patients with pandemic A/H1 2009 influenza or seasonal influenza virus infections. Patients aged >15 years received either neuraminidase inhibitors (control group) or clarithromycin plus neuraminidase inhibitors (clarithromycin group). Body temperature and other symptoms were recorded for 5 days after initiating treatment. Serum interleukin (IL)-6 and IL-8 levels were also measured. Results: Herein, 79 patients were enrolled over the two influenza seasons, and data from 63 patients were analyzed. All patients showed fever and other symptoms, including rhinorrhea (n=38), cough (n=50), sore throat (n=39), arthralgia or myalgia (n=46), and general malaise (n=50). Fever duration was approximately 42% shorter in patients with temperatures ≥38.5 °C (p=0.02), decreasing from 42. h to 24. h. Among patients with pandemic influenza infections (n=20), the rhinorrhea improvement rate was higher in the clarithromycin group (p=0.03; 88% vs. 20%). Serum IL-6 levels decreased 5 days after treatment, but no differences between the two groups were detected. Conclusions: Clarithromycin may have the additional clinical benefit of improving fever, the main symptom of influenza, in patients treated with neuraminidase inhibitors.
KW - Clarithromycin
KW - Fever
KW - Inflammation
KW - Influenza
KW - Neuraminidase inhibitor
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U2 - 10.1016/j.resinv.2014.05.001
DO - 10.1016/j.resinv.2014.05.001
M3 - Article
C2 - 25169846
AN - SCOPUS:84906790975
VL - 52
SP - 302
EP - 309
JO - Respiratory Investigation
JF - Respiratory Investigation
SN - 2212-5345
IS - 5
ER -