Banu AYDIN, Nihan HOŞAĞASI, Ayşegül ZENCİROĞLU, Nilgün KARADAĞ, Serdar BEKEN, Dilek DİLLİ, Nurullah OKUMUŞ

Yenidoğanlarda viral pnömonide oseltamivir kullanımı

Amaç: Yenidoğanlarda en sık pnömoni etkenleri sıklıkla bakteriyel olmakla birlikte daha az sıklıkta viral etkenler de saptanabilmektedir. Yöntemler: Bu çalışmada 2009-2013 yılları arasında Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi\'nde oseltamivir verilen hastalar retrospektif olarak değerlendirilmiştir. Hastaların demografik ve klinik bulguları ile tedavinin kaçıncı gününde klinik iyileşmenin sağlandığı, hastanede yatış süresi dosyalardan kayıt edilmiştir. Bulgular: Çalışma süresi boyunca kanıtlanmış H1N1 gribi (n=12) ve şüpheli vakalara (n=57) oseltamivir tedavisi verilen hastalar değerlendirilmeye alınmıştır. Ortalama doğum ağırlığı 3100±601 gram ve gestasyonel yaş 37.9±1.8 hafta; ortanca başvuru yaşı 20.6 (7-47) gün olarak bulunmuştur. Oseltamivir, bu vakalarda FDA\'nın acil kullanım izni doğrultusunda oral 3.0 mg/kg/doz, günde iki kez 5 gün boyunca kullanılmıştır. Hastaneye yatışın ardından oseltamivir başlama zamanı 2.3 (1-4) gün olarak saptanmıştır; hastanede yatış süresi ise 10,4 (5-22) gün olarak bulunmuştur. Tedavi sırasında olguların hiçbirinde oseltamivir ilişkili yan etkiler gözlenmemiştir ve tüm vakalar sağlıklı olarak taburcu edilmiştir. Sonuç: Ağır viral pnömoni düşünülen yenidoğan olgularda destek tedavilerinin yanı sıra oseltamivir verilmesi etkin ve güvenilir görülmektedir

Anahtar Kelimeler:

Pnömoni, yenidoğan, antiviral tedavi

Oseltamivir use for viral pneumonia in newborns

Objective: Viruses are demonstrated to be an uncommon etiologic agent of early and late pneumonia. In this study we aimed to investigate the safety and affectivity of oseltamivir use for viral pneumonia in newborns. Methods: This was a retrospective study conducted in a single tertiary neonatal intensive care unit between September 2009 and April 2013. Demographic, clinical and laboratory data before and after treatment, duration of hospitalization, time of clinical improvement were recorded. Results: During the study period, a total of 69 newborn cases who were treated by oseltamivir for H1N1 swine flu (n=12) or suspicious influenza (n=57) were evaluated. Mean birth weight and gestational age were 3100±601 grams and 37.9±1.8 weeks, respectively. On admission, median postnatal age was 20.6 (7-47) days. Oseltamivir, along with supportive care, was administered as 3.0 mg/kg/dose twice a day for 5 days according to the recommendations of Food and Drug Administration (FDA). The median time of initiation of oseltamivir was 2.3 days (1-4) after admission and the median hospitalization day was 10.4 days (5-22). No adverse effects associated with oseltamivir were observed and all patients were discharged after full recovery. Conclusion: Oseltamivir use in addition to supportive therapy seems to be safe and effective in newborns with severe viral pneumonia.

Keywords:

Pneumonia, newborn, antiviral treatment,

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