Tags

Type your tag names separated by a space and hit enter

Treatment of severe acute respiratory syndrome.
Eur J Clin Microbiol Infect Dis. 2005 Sep; 24(9):583-91.EJ

Abstract

The best treatment strategy for severe acute respiratory syndrome (SARS) is still unknown. Ribavirin and corticosteroids were used extensively during the SARS outbreak. Ribavirin has been criticized for its lack of efficacy. Corticosteroids are effective in lowering the fever and reversing changes in the chest radiograph but have the caveat of encouraging viral replication. The effectiveness of corticosteroids has only been suggested by uncontrolled observations, and the role of these agents in therapy remains to be established by randomized controlled studies. Both ribavirin and corticosteroids have very significant side effects. The lopinavir/ritonavir combination has been shown to reduce the intubation rate and the incidence of adverse clinical outcomes when used with ribavirin. When patients deteriorate clinically despite treatment with ribavirin and corticosteroids, rescue treatment with convalescent plasma and immunoglobulin may be beneficial. Noninvasive positive pressure ventilation is a sound treatment for SARS patients with respiratory failure if administered with due precaution in the correct environment. Interferons and other novel agents may hold promise as useful anti-SARS therapies in the future. The experience with traditional Chinese medicine is encouraging, and its use as an adjuvant should be further investigated.

Authors+Show Affiliations

Division of Infectious Disease, Department of Medicine, Princess Margaret Hospital, 2-10, Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China. laist@ha.org.hk

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16172857

Citation

Lai, S T.. "Treatment of Severe Acute Respiratory Syndrome." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 24, no. 9, 2005, pp. 583-91.
Lai ST. Treatment of severe acute respiratory syndrome. Eur J Clin Microbiol Infect Dis. 2005;24(9):583-91.
Lai, S. T. (2005). Treatment of severe acute respiratory syndrome. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 24(9), 583-91.
Lai ST. Treatment of Severe Acute Respiratory Syndrome. Eur J Clin Microbiol Infect Dis. 2005;24(9):583-91. PubMed PMID: 16172857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of severe acute respiratory syndrome. A1 - Lai,S T, PY - 2005/9/21/pubmed PY - 2005/12/24/medline PY - 2005/9/21/entrez SP - 583 EP - 91 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 24 IS - 9 N2 - The best treatment strategy for severe acute respiratory syndrome (SARS) is still unknown. Ribavirin and corticosteroids were used extensively during the SARS outbreak. Ribavirin has been criticized for its lack of efficacy. Corticosteroids are effective in lowering the fever and reversing changes in the chest radiograph but have the caveat of encouraging viral replication. The effectiveness of corticosteroids has only been suggested by uncontrolled observations, and the role of these agents in therapy remains to be established by randomized controlled studies. Both ribavirin and corticosteroids have very significant side effects. The lopinavir/ritonavir combination has been shown to reduce the intubation rate and the incidence of adverse clinical outcomes when used with ribavirin. When patients deteriorate clinically despite treatment with ribavirin and corticosteroids, rescue treatment with convalescent plasma and immunoglobulin may be beneficial. Noninvasive positive pressure ventilation is a sound treatment for SARS patients with respiratory failure if administered with due precaution in the correct environment. Interferons and other novel agents may hold promise as useful anti-SARS therapies in the future. The experience with traditional Chinese medicine is encouraging, and its use as an adjuvant should be further investigated. SN - 0934-9723 UR - https://www.unboundmedicine.com/medline/citation/16172857/Treatment_of_severe_acute_respiratory_syndrome_ L2 - https://dx.doi.org/10.1007/s10096-005-0004-z DB - PRIME DP - Unbound Medicine ER -