Pediatrics & Therapeutics
Open Access

Abstract

Incomplete Inhalation of Laninamivir Octanoate in Children with Influenza

Yoshiki Katsumi, Osamu Otabe, Satoshi Sakaue, Yusuke Tsuma, Mihoko Yamaguchi, Fumihiro Matsui, Masaya Suematsu, Satoshi Miyagaki and Hisato Ito

Background: Laninamivir octanoate (LO), an inhaled neuraminidase inhibitor, has been used against influenza in Japan. However, children who cannot inhale well might not receive the full dose. We examined the relation between the residual amounts of LO in the device after its use and the time to fever resolution in children with influenza.

Methods: The subjects of the study were 161 children (4-15 years) who had been diagnosed as having influenza from 2011-2014 and who had demonstrated an ability to properly use an inhalation training device. After its use, the LO device was returned to the authors and the residual amount of LO was measured. After flu symptoms had resolved, the patients’ parents reported the time to fever resolution in a questionnaire. Results: The percentage of the residual LO was not significantly correlated with the time to fever resolution or with patient age. The percentage of residual LO tended to be higher and the time to fever resolution tended to be longer in 4-6 year-olds than in older children. In the 4-6 year group, seven patients were inhaling steroids. These patients tended to inhale more of the LO dose and tended to have a shorter time to fever resolution than the other patients. Conclusions: Physicians need to be aware that some 4-6 year-old influenza patients will not be able to inhale the full dose of LO. Influenza patients, even young ones, who are also inhaling steroids for other conditions are better able to inhale LO.