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題名 | Ribavirin用於小兒腺病毒個案=Oral Ribavirin for the Treatment of Severe Adenovirus Infection in a Child |
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作者姓名(中文) | 陳宛君; 高毓璐; | 書刊名 | 藥學雜誌 |
卷期 | 31:4=125 2015.12[民104.12] |
頁次 | 頁79-83 |
分類號 | 418.285 |
關鍵詞 | 腺病毒感染; 呼吸道感染; Ribavirin; |
語文 | 中文(Chinese) |
中文摘要 | 腺病毒感染 (Adenovirus,AdV) 常引起兒童呼吸道感染及住院,臨床症狀包含咽 喉結膜熱、流行性角膜結膜炎,雖然症狀常是輕微,但在免疫不全病人,嚴重可能 引起肺炎、腸炎、出血性膀胱炎、肝炎、腎炎、腦炎或者瀰漫性感染引起多重器官 衰竭。藥物治療部分,曾有臨床個案使用 cidofovir 與 ribavirin,但目前文獻並不完 整,也缺乏大型臨床隨機分配試驗。本文報告案例為一7個月大,無先天免疫不全病 史女嬰,因腺病毒感染高燒入院,引起肺炎併發腦部感染、心肌炎及肝炎。期間以 oseltamivir 與 acyclovir 治療皆未見改善,經醫師及藥師討論,改以 ribavirin 口服治療 7天後,順利脫離體外心肺循環系統,臨床症狀也漸有改善。Ribavirin 治療常見副作 用包括與劑量相關的貧血、嘔吐、頭痛、失眠等,在本案例使用前後血色素皆維持正 常範圍,無其他藥物相關副作用發生。腺病毒感染雖多為自限性的,但在較高風險導 致瀰漫性感染的病人族群,及早確診並儘早投予抗病毒藥物,對後續治療反應評估是 較佳的。此幼兒個案以口服 ribavirin 治療腺病毒感染,使用藥物後,其臨床症狀雖明 顯改善,但仍需要更多文獻資料及臨床經驗佐證,以實際應用口服 ribavirin 於嬰幼兒 之腺病毒感染。 |
英文摘要 | Adenovirus is a common and major cause of respiratory tract infection and hospitalization in children. Most adenovirus infection is typically mild, self-limiting, and frequently associated with upper respiratory tract symptoms. However in immunocompromised children, the consequences may be more severe and may progress to pneumonia, hepatitis, myocarditis, meningoencephalitis, nephritis or multiple-organ failure. Clinical experience in the treatment of severe adenovirus infection is limited to a few case reports and the efficacy of antiviral, such as cidofovir or ribavirin, remains controversial. This case report describes the use of oral ribavirin for the treatment of adenovirus infection in a 7 month old child. She was admitted to our hospital for evaluation of her respiratory tract syndromes with spiking temperature. Her condition deteriorated during admission with the development of pneumonia, meningoencephalitis and myocarditis. After 7 days of oral ribavirin therapy, clinical symptoms improved gradually and she was taken off extracorporeal membrane oxygenation support. No major side effects of ribavirin, such as anemia, nausea, headache and insomnia, were noted. Hemoglobin values of our patient remained within normal range. Even though adenovirus infection is mostly self-limiting, early identification of this disease allows earlier antiviral treatment and improve patient prognosis. This observation illustrates the potential value of oral ribavirin in a child with severe adenovirus infection. However, the efficacy of ribavirin still remains controversial and further large prospective multicenter trials are required. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。