{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T10:22:42Z","timestamp":1789899762008,"version":"4.0.1"},"reference-count":42,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T00:00:00Z","timestamp":1322697600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>A recent<jats:italic>in vitro<\/jats:italic>study showed that the three compounds of antiviral drugs with different mechanisms of action (amantadine, ribavirin, and oseltamivir) could result in synergistic antiviral activity against influenza virus. However, no clinical studies have evaluated the efficacy and safety of combination antiviral therapy in patients with severe influenza illness. A total of 245 adult patients who were critically ill with confirmed pandemic influenza A\/H1N1 2009 (pH1N1) virus infection and were admitted to one of the intensive care units of 28 hospitals in Korea were reviewed. Patients who required ventilator support and received either triple-combination antiviral drug (TCAD) therapy or oseltamivir monotherapy were analyzed. A total of 127 patients were included in our analysis. Among them, 24 patients received TCAD therapy, and 103 patients received oseltamivir monotherapy. The 14-day mortality was 17% in the TCAD group and 35% in the oseltamivir group (<jats:italic>P<\/jats:italic>= 0.08), and the 90-day mortality was 46% in the TCAD group and 59% in the oseltamivir group (<jats:italic>P<\/jats:italic>= 0.23). None of the toxicities attributable to antiviral drugs occurred in either group of our study, including hemolytic anemia and hepatic toxicities related to the use of ribavirin. Logistic regression analysis indicated that the odds ratio for the association of TCAD with 90-day mortality was 0.58 (95% confidence interval, 0.24 to 1.42;<jats:italic>P<\/jats:italic>= 0.24). Although this study was retrospective and did not provide virologic outcomes, our results suggest that the treatment outcome of the triple combination of amantadine, ribavirin, and oseltamivir was comparable to that of oseltamivir monotherapy.<\/jats:p>","DOI":"10.1128\/aac.05529-11","type":"journal-article","created":{"date-parts":[[2011,10,4]],"date-time":"2011-10-04T04:10:31Z","timestamp":1317701431000},"page":"5703-5709","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":58,"title":["Triple-Combination Antiviral Drug for Pandemic H1N1 Influenza Virus Infection in Critically Ill Patients on Mechanical Ventilation"],"prefix":"10.1128","volume":"55","author":[{"given":"Won-Young","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gee","family":"Young Suh","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Won","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Han","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-ju","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Seong","family":"Kim","sequence":"additional","affiliation":[{"name":"Pusan National University School of Medicine, Pusan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye-Ryoun","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea Cancer Center Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yon Ju","family":"Ryu","sequence":"additional","affiliation":[{"name":"Ewha Womans University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Soo","family":"Han","sequence":"additional","affiliation":[{"name":"Eulji University School of Medicine, Daejon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Gwan","family":"Ko","sequence":"additional","affiliation":[{"name":"School of Medicine, Kyung Hee University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyu Rak","family":"Chon","sequence":"additional","affiliation":[{"name":"Konkuk University School of Medicine, Cheungju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwan Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Medicine, Yeungnam University, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Bum","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Korean Society of Critical Care Medicine (KSCCM) H1N1 Collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0707279"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.092127"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1986.00360210129019"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.3.7509706"},{"key":"e_1_3_3_6_2","unstructured":"CDC. 2010. 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