From the Journals

AAP adds peramivir to influenza recommendations


The American Academy of Pediatrics Committee on Infectious Diseases has added information on peramivir, a recently approved antiviral medication, to its Recommendations for Prevention and Control of Influenza in Children for 2017-2018.

Peramivir (Rapivab) was approved by the Food and Drug Administration in September 2017, as an intravenous treatment for acute, uncomplicated influenza in nonhospitalized children aged 2 years and older who have been symptomatic for no more than 2 days, according to the update.

Peramivir is given to 2-12 year olds as a single infusion at 12 mg/kg, with a maximum dose of 600 mg, according to the guideline update ( Pediatrics. 2017 Oct;140[4]:e20172550 ). Patients 13 years and older should receive the 600-mg dose.

“Rapivab is a great addition to our armamentarium of antiviral agents to combat influenza,” John A. Vanchiere, MD , PhD, chief of the section of pediatric infectious diseases at LSU Health Sciences Center, Shreveport. said in a press release from the drug’s manufacturer, BioCryst Pharmaceuticals . “It will be especially helpful for patients who cannot tolerate oral medications. In addition, the long half-life allows for one-time dosing, which will improve compliance.”

Dr. Vanchiere is the lead author in a study of peramivir’s effectiveness against pediatric influenza that was presented as a poster at ID Week 2017.

The phase 3, randomized, control trial included 122 patients, ranging in age from newborns to 18-year-olds, with acute uncomplicated influenza symptoms.

Investigators gave 92 patients peramivir, while the remaining 23 received oral oseltamivir (Tamiflu).

Nearly all (93%) of the patients were white; 61% had an influenza A strain infection, and there were comparable numbers of male and female study subjects.

Vomiting, fever, and tympanic membrane erythema were the most common adverse effects specifically reported in the study, which was funded by BioCryst.

Peramivir is the third neuraminidase inhibitor (NAI) to be approved; other approved NAIs include oral oseltamivir and inhaled zanamivir.

A fourth NAI, intravenous zanamivir, is still investigational in the United States.

Peramivir, like other antiviral drugs, may interfere with a live attenuated influenza vaccine and should not be used within 2 weeks after or 48 hours before the use of an LAIV.

While the AAP’s recommendations highlight the antiviral’s effectiveness in controlling influenza, the Academy warns that antivirals are not a substitute for influenza vaccination.

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