A Comparison of the Frequency of Prescription and Pharmacy Revisits between Baloxavir Marboxil and Neuraminidase Inhibitors in Influenza-Infected Pediatric Patients during the 2019-2020 Influenza Season.

The novel anti-influenza virus agent baloxavir marboxil is a selective inhibitor of an influenza cap-dependent endonuclease. Although a single oral dose in tablet form of baloxavir marboxil is expected to improve drug compliance and rapidly reduce viral titers for pediatric patients with influenza, there is a concern that baloxavir marboxil-resistant influenza A variants could be generated. In this study, we investigated the frequency of prescription and pharmacy revisits for baloxavir marboxil at an outpatient clinic compared with that of neuraminidase inhibitors in pediatric patients with influenza. A total of 475 pediatric patients who were infected with the influenza virus visited the pharmacy between December 2019 and March 2020. Baloxavir marboxil (n = 149), oseltamivir (n = 161) and laninamivir (n = 162) were mainly prescribed and only a few patients were treated with peramivir (n = 2) or zanamivir (n = 1). Baloxavir marboxil-, oseltamivir- and laninamivir-treated pediatric patients were enrolled, and a log-rank test showed that the revisits of pediatric patients who were taking baloxavir marboxil was lower than those for oseltamivir (p < 0.001). Moreover, Cox proportional hazards models also revealed that baloxavir marboxil decreased the risk of revisits in comparison to oseltamivir (hazard ratio 0.28, 95% confidence interval 0.11-0.70, p = 0.006), while no difference was found between laninamivir and baloxavir marboxil. Although there is a need to acquire appropriate and relevant information concerning resistant viruses, our results suggest that baloxavir marboxil may be a useful drug for treating pediatric patients with influenza infections.

[Evaluation of the Usefulness of a Completely Separated Infection Waiting Room and Non-infection Waiting Room in a Pediatric Neighborhood Pharmacy].

Because patients and their families are at a high risk of contracting infectious diseases in hospital as well as pharmacy, a pharmacy containing the waiting rooms separately for infectious diseases and non-infectious diseases is expected to lead them to visit with confidence and receive appropriate drug administration guidance without the risk of infection. In this study, we examined the potential usefulness of having separate waiting rooms by conducting a questionnaire survey on the structure of the pharmacy waiting room and investigating the visiting situation for influenza-infected pediatric patients from a record of the medicines they received. As a result of the questionnaire tabulated from guardians of 385 pediatric patients who first visited a pharmacy with separate waiting rooms, 70% of the pediatric patients concluded that having separate waiting rooms would be satisfactory. In addition, the possible risk of horizontal transmission of influenza was supposed to be reduced in the pharmacy with separate waiting room in comparison with the pharmacies without among 211 pediatric patients who could not identify the influenza source within their daily living areas, such as home and school. Based on these findings, we anticipate the growing availability of the pharmacies having separation type waiting rooms.