A new case report in Lancet documents the first use of IV zanamivir in a patient with respiratory failure from H1N1. Sequential testing of the H1N1 viral load in bronchoalveolar lavage fluid suggests that the novel therapy was effective after trials of oral oseltamivir and nebulized zanamivir were not. Of course, as I teach our first year medical students in their epidemiology course, case reports are prone to over-interpretation. Nonetheless, given the dearth of therapeutic options for patients with severe manifestations of H1N1, this new option deserves further study.
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