Rapivab (peramivir) / BioCryst, Shionogi - LARVOL DELTA

Comprehensive evaluation of therapeutic effectiveness and safety profiles of baloxavir marboxil for managing influenza virus infection in pediatric populations: a systematic review with pooled meta-analytic data. (PubMed, Front Pediatr) - "A random-effects model meta-analysis demonstrated that, compared to neuraminidase inhibitors (oseltamivir, zanamivir, peramivir, laninamivir), baloxavir marboxil achieved accelerated resolution of febrile symptoms (MD = -13.16 h, 95% CI: -19.16 to -7.15, P < 0.0001)...However, continuous monitoring for baloxavir-resistant mutations (such as PA/I38T) in the pediatric population is warranted. Furthermore, confirmation through large-scale multicenter trials with extended follow-up periods remains warranted."

Journal • Review • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

Isolation, identification, and whole genome sequencing analysis of influenza A virus clinical isolates from Shanghai, China, during 2022-2023. (PubMed, Virol J) - "Mutational analysis identified key substitutions in the hemagglutinin and neuraminidase regions, including the I222V mutation in the neuraminidase segment of sample B623080303, which is associated with strong resistance to oseltamivir and peramivir. Another highly drug-resistant N206D mutation in the hemagglutinin region, detected in four clinical isolates, was found to alter host specificity by reducing binding affinity to human-like α2,6-linked receptors while increasing affinity for avian-like α2,3-linked receptors, thereby influencing host adaptation dynamics. The findings provide critical insights into the evolutionary trends of influenza A virus strains post-COVID-19 pandemic and their potential implications for vaccine effectiveness and antiviral resistance."

Journal • Infectious Disease • Influenza • Novel Coronavirus Disease • Pediatrics • Respiratory Diseases

Integrated Phenotypic-Genotypic Surveillance of Neuraminidase Inhibitor Susceptibility in Influenza A(H1N1), A(H3N2), and B/Victoria Viruses in Saudi Arabia, 2024-2025. (PubMed, J Med Virol) - "Influenza B virus displayed a reproducible oseltamivir right-shift linked to non-canonical framework/interface substitutions, whereas zanamivir and especially peramivir retained activity. These findings support ongoing integrated phenotype-genotype surveillance and consideration of peramivir when influenza B circulation is substantial."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Theoretical, biological, and electrochemical explanation of the complexity of Peramivir's drug-DNA interaction. (PubMed, Sci Rep) - "Complementarily plasmid relaxation assays indicate that PMV does not cause significant DNA damage such as single- or double-strand breaks, but also does not provide any protection against oxidative DNA damage. These findings imply that the drug's mechanism of action is centred more on molecular interaction with DNA rather than on compromising its structural integrity."

Journal • Infectious Disease • Influenza • Respiratory Diseases

A literature review of influenza chemoprophylaxis and treatment in children. (PubMed, Germs) - "In Europe, oseltamivir, zanamivir, and baloxavir marboxil are recommended for the treatment or prophylaxis of influenza in adults and children, while the Food and Drug Administration added intravenous peramivir to the list of anti-influenza drugs...However, there are still discussions related to the duration of prophylaxis, with shorter periods of administration being explored, or the most efficient treatment dosage program (whether it is the conventional dosage of 3 mg/kg/dose for children <40 kg or 75 mg for adults, twice daily, compared to a double dosage administration program). When faced with an old disease, it is essential to constantly assess the efficacy of conventional molecules and dosages, along with new antivirals or complementary medication."

Journal • Review • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

The Republic of Korea 2023-2024 Influenza and Respiratory Viruses Laboratory Surveillance Report (PubMed, Jugan Geongang Gwa Jilbyeong) - "Further, no mutations associated with resistance to antiviral drugs (Oseltamivir, Zanamivir, and Peramivir, Baloxavir) were identified...The continuous surveillance of influenza and respiratory virus trends is essential to inform vaccine strain selection and enhance public health response strategies. Our division will conduct continuous surveillance of the epidemiological trends of respiratory viruses, including influenza, and ensure the timely provision of data for public health interventions."

Journal • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections

PRONING UNDER PRESSURE: MULTIMODAL NEUROLOGIC MONITORING IN SPONTANEOUS INTRACRANIAL HEMORRHAGE COMPLICATED BY REFRACTORY ARDS REQUIRING VV-ECMO (CHEST 2025) - "She was placed on vancomycin, ceftriaxone, and peramivir. This case represents a successful balancing of management of acute brain and lung injury with the use of invasive and non-invasive neuromonitoring concomitant with severe ARDS management (prone positioning, VV-ECMO) which has a risk of worsening brain injury."

Acute Respiratory Distress Syndrome • Anesthesia • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Infectious Disease • Influenza • Pneumonia • Respiratory Diseases • Vascular Neurology

FATAL TRACHEOBRONCHIAL ASPERGILLOSIS AFTER H1N1 INFLUENZA INFECTION (CHEST 2025) - "The patient was initiated on peramivir and broad-spectrum antibiotics.Despite gradual improvement in renal function, the patient's respiratory status deteriorated, necessitating high-flow nasal cannula oxygen and intermittent noninvasive ventilation. Subsequent sputum cultures grew Aspergillus fumigatus, prompting the initiation of voriconazole therapy... This case highlights the potential for fatal TBA following H1N1 influenza infection, even in patients without classic immunosuppressive risk factors. Clinicians should maintain a high index of suspicion for invasive aspergillosis in critically ill influenza patients, particularly those with underlying pulmonary conditions or a history of substance use. Early recognition and prompt antifungal therapy are crucial to improving outcomes in this population."

Cardiovascular • Hypertension • Infectious Disease • Influenza • Ischemic stroke • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Septic Shock

Comparison table: Antiviral drugs for seasonal influenza for 2025-2026. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Infectious Disease • Influenza • Respiratory Diseases

Antiviral drugs for seasonal influenza for 2025-2026. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Infectious Disease • Influenza • Respiratory Diseases

Antiviral susceptibility monitoring: testing algorithm, methods, and findings for influenza season, 2023-2024. (PubMed, Antiviral Res) - "Viral genome sequence analysis was the primary approach to assess susceptibility to M2 blockers (n=5123), neuraminidase (NA) inhibitors (n=6874), and a polymerase acidic protein (PA) inhibitor (baloxavir, n=6567)...Although oseltamivir-resistant viruses carrying NA-H275Y (N1 numbering) were rare (0.35%), a cluster of four such viruses was identified in Haiti...This includes a cluster of three influenza B viruses in Texas that shared a new mutation, NA-A245G conferring reduced inhibition by peramivir...To monitor baseline susceptibility, supplementary in vitro testing was conducted on approximately 7% of viruses using NA inhibition assay and cell culture-based assay IRINA. Implementation of Sequence First approach provided comprehensive and high throughput methodology for antiviral susceptibility assessment and reduced redundant phenotypic testing."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Influenza vaccines for 2025-2026. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Hepatitis B • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections

Aryl benzoyl hydrazide derivatives as potent inhibitors of the NS2B-NS3 protease and RNA-dependent RNA polymerase of the zika virus. (PubMed, In Silico Pharmacol) - "To identify molecules that can strongly bind to the substrate binding site of the NS2B-NS3 protease of the ZIKV, interactions of several aryl benzoyl hydrazide (ABH) derivatives (10b, 10c, 10g, 11p, and 11q) and some anti-influenza drugs (Zanamivir, Laninamivir, Baloxavir, Oseltamivir, Rimantadine, Peramivir, and Amantadine) with the ZIKV NS2B-NS3 protease are studied herein by using combined density functional theoretic, docking, molecular dynamics (100 ns MD simulations), and free-energy methods...Computed ADMET parameters, Lipinski's rule of five, and binding affinities suggest that 11q would be a better drug candidate against ZIKV infections. The online version contains supplementary material available at 10.1007/s40203-025-00395-5."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Clinical features and prognosis of children with influenza-associated encephalopathy: an analysis of 23 cases (PubMed, Zhongguo Dang Dai Er Ke Za Zhi) - "Fever and convulsions are the most common symptoms of children with IAE, and acute necrotizing encephalopathy is the most common clinical imaging syndrome. Increases in alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase have a certain value in predicting poor prognosis."

Journal • Retrospective data • CNS Disorders • Epilepsy • Infectious Disease • Influenza • Respiratory Diseases

Global update on the susceptibilities of influenza viruses to neuraminidase inhibitors and the cap-dependent endonuclease inhibitor baloxavir, 2020-2023. (PubMed, Antiviral Res) - "This study describes a global analysis of the susceptibility of influenza viruses to neuraminidase (NA) inhibitors (NAIs, oseltamivir, zanamivir, peramivir, laninamivir) and the cap-dependent endonuclease inhibitor (CENI, baloxavir) for three periods (May to May for 2020-2021, 2021-2022 and 2022-2023)...For zoonotic viruses, 2.7% (3/111) contained substitutions, one each NA-H275Y, NA-S247N and NA-N295S, associated with RI/HRI NAI phenotypes, and none contained PA substitutions associated with RS to baloxavir. In conclusion, the great majority of seasonal and zoonotic influenza viruses remained susceptible to NAIs and CENI baloxavir."

Journal • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases

Development of molnupiravir and peramivir loaded liposome formulations for combined antiviral therapy. (PubMed, Pharm Dev Technol) - "These findings demonstrate that a possible synergistic effect of the newly developed sustained-release COMB-Lipo formulation is suggested with the complementary antiviral mechanisms of the combined agents. As a result, the therapeutic potential of co-delivery of anti-SARS-CoV-2 drugs for pulmonary application is considered a promising approach for long-acting treatment of COVID-19."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Severe Influenza Patients Who Received Ventilator Management During the 2024 to 2025 Major Influenza-Endemic Season in a Tertiary Hospital in Japan. (PubMed, Int Med Case Rep J) - "Intravenous peramivir and piperacillin/tazobactam were administered for 2 days followed by lascufloxacin and linezolid for 2 weeks...He showed severe hypoxia and massive ground-glass opacities (GGOs) in both lung fields, but he recovered after administration of peramivir and levofloxacin with prednisolone for 2 days and 2 weeks, respectively, with non-invasive positive pressure support...All three patients had not received influenza vaccines and were not elderly. Although the emphasis on most vaccines has decreased after the COVID-19 pandemic appears to have subsided, we should stress the importance of influenza vaccines and improvement of critical care protocols, because severe influenza can be a concern for young and middle-aged adults during the influenza season after the post COVID-19 pandemic period."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Critical care • Genetic Disorders • Heart Failure • Hematological Malignancies • Infectious Disease • Inflammation • Influenza • Multiple Myeloma • Nephrology • Novel Coronavirus Disease • Obesity • Oncology • Pneumonia • Renal Disease • Respiratory Diseases

FIFTY-YEAR ANALYSIS OF INFLUENZA VACCINE EFFECTIVENESS AND ANTIVIRAL USE PATTERNS THROUGH MACHINE LEARNING: IMPLICATIONS FOR PAEDIATRIC INFLUENZA MANAGEMENT (ESPID 2025) - "Data were stratified by virus subtypes, including Influenza A(H1N1), A(H3N2), and Influenza B, as well as by the use of major antivirals such as Amantadine, Rimantadine, Zanamivir, Oseltamivir, Peramivir, and Baloxavir...Conclusions/Learning Points This analysis highlights the dynamic nature of influenza vaccine effectiveness and antiviral medication consumption over five decades. The findings underscore the necessity of ongoing research, global surveillance, and adaptability in influenza prevention and treatment strategies to address changing epidemiological patterns, particularly in vulnerable populations such as children."

Machine learning • Infectious Disease • Influenza

Improving Antiviral Use in Children Hospitalized with Influenza (PAS 2025) - "Outcome measure was the percentage of encounters with at least one dose of a hospital formulary antiviral (oseltamivir or peramivir) administered. Baseline consisted of 143 encounters with antiviral treatment administered in 74.8% of encounters. There has not been a shift in the center line in the outcome measure, though 7 of last 8 points are above centerline (Figure 2). Special cause variation (SCV) was seen in our process measure with a shift in the center line from 4.9 hours to 2.4 hours following educational interventions (Figure 3)."

Clinical • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

How to manage antivirals in critically ill patients with Influenza? (PubMed, Clin Microbiol Infect) - "Neuraminidase inhibitors constitute the vast majority of antivirals currently prescribed for influenza. The most commonly prescribed NAI to date is oseltamivir. While its efficacy in non-severe cases of influenza is well established, the evidence for its efficacy in critically ill patients is based on less robust studies, as no randomised controlled trials have been conducted in this population. Limited data on oseltamivir pharmacokinetics is available in critically ill patients. The selection of A(H1N1)pdm09 resistant variants to oseltamivir is particularly problematic in critically-ill patients hospitalised in intensive care units. Data on other antivirals, including NAIs (i.e., zanamivir, peramivir and laninamivir) or baloxavir marboxil in critically ill patients are scarce. Further research is needed to develop new drugs and assess their efficacy in critically ill patients and to better assess the effect of oseltamivir in this population."

Journal • Review • Critical care • Infectious Disease • Influenza • Respiratory Diseases

Preparation and comprehensive preclinical study of Peramivir inhalation solution: Achieving accurate drug delivery. (PubMed, Biomed Pharmacother) - "In this study, we focused on the reformulation of Peramivir from intravenous to inhalation administration, conducting comprehensive research on its toxicity, tissue distribution, pharmacokinetics, and pharmacodynamics. We demonstrated that PIS, compared to intravenous administration, exhibited heightened local drug exposure in lung tissues, longer exposure duration, slower elimination, and exhibited good tolerability without specific safety concerns."

Journal • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

New Function for Safety Signal Monitoring in MID-NET®: The Case of an Anti-COVID-19 Drug. (PubMed, Clin Transl Sci) - "We monitored the safety signals of an anti-COVID-19 drug (combination of tixagevimab and cilgavimab) and compared them with those of two controls (peramivir and the combination of casirivimab and imdevimab) to examine the practical utility of this new tool. Our study provided helpful information (e.g., new safety signals) on many outcomes at multiple time points, which could enhance the understanding of drug safety profiles soon after approval. Our function can be used to rapidly and continuously monitor drug safety signals and contribute to strengthening drug safety monitoring in Japan."

Journal • Infectious Disease • Novel Coronavirus Disease

Antiviral Susceptibility of Influenza A(H5N1) Clade 2.3.2.1c and 2.3.4.4b Viruses from Humans, 2023-2024. (PubMed, Emerg Infect Dis) - "In the neuraminidase inhibition assay, all viruses displayed susceptibility to neuraminidase inhibitor antiviral drugs oseltamivir, zanamivir, peramivir, laninamivir, and AV5080...All viruses were susceptible to polymerase inhibitors baloxavir and tivoxavir and to polymerase basic 2 inhibitor pimodivir with 50% effective concentrations in low nanomolar ranges. Because drug-resistant viruses can emerge spontaneously or by reassortment, close monitoring of antiviral susceptibility of H5N1 viruses collected from animals and humans by using sequence-based analysis supplemented with phenotypic testing is essential."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Fatal Cerebral Complications in Disseminated Mucormycosis after Influenza-associated Pneumonia in an Immunocompromised Patient: An Autopsy Case Report (AAN 2025) - "Despite treatment with cefepime, peramivir, and increased corticosteroids, her condition worsened, leading to left hemiplegia and severe consciousness disturbance on hospital day 3. This rare case underscores the need to consider opportunistic infections, such as mucormycosis, in immunocompromised patients exhibiting neurological symptoms post-influenza. Early identification and antifungal treatment are crucial for improving outcomes in similar cases. Advanced diagnostic techniques may enhance the detection and management of such infections."

Case report • Clinical • Cardiovascular • CNS Disorders • Diabetes • Hematological Disorders • Hematological Malignancies • Infectious Disease • Inflammation • Influenza • Ischemic stroke • Metabolic Disorders • Myelodysplastic Syndrome • Oncology • Pneumonia • Respiratory Diseases • Vasculitis • IL6

Native Capillary Nanogel Electrophoresis Assay of Inhibitors of Neuraminidases Derived from H1N1 and H5N1 Influenza A Pandemics. (PubMed, Anal Chem) - "The inhibition constants for oseltamivir acid (inhibiting compound of Tamiflu) and peramivir (Rapivab) are 18.2 ± 0.5 nM (n = 3) and 67 ± 8 nM (n = 3), respectively. For 2004 H5N1 (A/Vietnam/1203/2004) neuraminidase, which contained a foreign tetramerization domain to maintain the structure, the inhibition constant for peramivir is 5.4 nM."

Journal • Infectious Disease • Influenza • Respiratory Diseases