BMJ Best Practice

证据

  • In healthy adults, what are the benefits and harms of vaccines for preventing influenza?
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  • In healthy children, what are the benefits and harms of vaccines for preventing influenza?
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  • Does randomized controlled trial evidence support the use of vaccines to prevent influenza in the elderly?
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  • What are the benefits and harms of neuraminidase inhibitors for the treatment of influenza in otherwise healthy adults?
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  • In children with clinically or serologically confirmed influenza A, do amantadine and rimantadine improve outcomes?
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  • If there is an outbreak of influenza A in the community, do amantadine and rimantadine given prophylactically prevent the development of influenza in children?
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  • If there is an outbreak of influenza A in the community, do amantadine and rimantadine given prophylactically prevent the development of influenza in the elderly?
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  • What are the benefits and harms of neuraminidase inhibitors for the prevention of influenza in adults?
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证据评分

    证据 A

    疫苗对健康成年人有效：有高质量的证据表明，健康成年人接种流感减毒活疫苗或灭活疫苗可高度有效预防感染。[61][62][63][64][65]

    证据 A

    预防症状：有高质量的证据表明，口服吸入型扎那米韦在预防流感症状方面比安慰剂更有效，但不能预防流感样疾病。此外，在一项针对 29 项随机对照治疗试验的 meta 分析中，奥司他韦和扎那米韦对流感症状缓解时间的风险比分别为 1.33 和 1.30，前提是症状发作后 48 小时内开始治疗。[134] 来自随机对照试验的证据一致支持奥司他韦和扎那米韦在治疗和预防流感方面具有临床疗效的观点。[129]

    证据 C

    儿童诊断的关键因素：有低质量的研究显示发热和咳嗽对儿童季节性流感有预测价值。一些针对儿童的研究发现，在 5 岁至 12 岁的儿童中，同时出现发热和咳嗽症状对诊断流感的阳性预测值为 71%-83%，而此预测值在 <5 岁的儿童中为 64%。[90] 在一项大样本的监测研究中，所有发热或急性呼吸道感染的症状的患儿进行了流感测试，实验室确诊的流感病例中报告有发热，咳嗽症状，小于6个月的住院儿童为70%，6个月~5岁的住院患儿为91%。[90]

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