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Paper Chase #1 | Baloxavir for Uncomplicated Flu

Steve Biederman, MD and Tom Robertson, MD
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BOTTOM LINE: Single-dose baloxavir was without evident safety concerns, was superior to placebo in alleviating influenza symptoms, and was superior to both oseltamivir and placebo in reducing the viral load 1 day after initiation of the trial regimen in patients with uncomplicated influenza. Evidence for the development of decreased susceptibility to baloxavir after treatment was also observed.

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Ian L., Dr -

It would be of value to know if early administration of Baloxavir had a greater effect.
In 2003 Aoki FY et al in JAntimicrob Chemother Jan 51(1) 123-129 found in a trial of over 1400 patients 67% of which had influenza confirmed by tests that administration of Oseltamivir within 12 hours of onset of fever in suspected influenza reduced disease by 3.1 Days as compared to intervention at 48 Hours .
There was reduced duration of fever severity of symptoms and reduced time to return to baseline health .
The Baloxavir study was completed on healthy uncomplicated patients .
Of note a small percentage of influenza viruses developed gene changes reducing their susceptibility to Baloxavir .
So the concept of very early administration of antivirals in high risk patients is clinically vital to validate .
Certainly Chemoprophylaxis of high risk contacts reduced burden of influenza in aged care communities by 55% according to latest CDC publications .

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Hello, New Year! Bye Bye, PPIs? Full episode audio for MD edition 201:19 min - 94 MB - M4APC RAP January 2019 Written Summary 386 KB - PDF

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