Clinical Question: Are antiviral me...

Clinical Question: Are antiviral medications effective in preventing influenza or treating healthy adults with influenza?

Setting: Outpatient (any)

application of mind Design: Systematic review

Synopsis: The authors searched multiple databases for randomized controll trials of antiviral medications used for treating healthy adults 16 to 65 years of age with influenza. They also sought unpublished studies. couple authors independently decided which studies to include and assessed the quality of the included studies, and a third member of the team settl discrepancies.

They analyzed 20 prophylaxis studies and 13 treatment trials using the M2 ion blocker amantadine (Symmetrel) and rimantadine (Flumadine). Additionally, they analyzed 19 studies of the neuraminidase inhibitors zanamivir (Relenza) and oseltamivir (Tamiflu) as prophylaxis, treatment, and postexposure prophylaxis.

In the prophylaxis studies, amantadine precludeed 61 percent of influenza A cases if it be not that only 25 percent of influenza-like illnesses. Adverse purports caused more patients to stop taking amantadine than placebo. Rimantadine was no better than placebo in preventing influenza and influenza-like illness and also was more likely to cause adverse tenors that resulted in medication cessation. The neuraminidase inhibitors were no better than placebo in prophylaxis against influenza-like illness. Oseltamivir obstructed 54 percent of influenza cases and zanamivir intercepted 43 percent. In a single reflection the neuraminidase inhibitors prevented lower respiratory tract infections in confirmed influenza cases however not in influenza-like illnesses. The authors were unable to find any rigorous studies of oseltamivir in succession cases of avian influenza. The authors do not provide enough detail to calculate numbers straited to treat or to harm.

Bottom Line: Antiviral agents are merely slightly effective in preventing confirmed influenza or influenza-like illness. When given in the first hardly any days of illness, the M2 ion blocker and neuraminidase inhibitors bring the duration of illness from approximately one day. (Level of Evidence: 1a)

HENRY BARRY, MD MS

close attention Reference: Jefferson T, et al. Antivirals for influenza in healthy adults: systematic review. Lancet January 28 2006;367:303-13

Used with permission from Barry H Antivirals slightly effective for influenza in healthy adults. Accessed March 29 2006 at: http://www.InfoPOEMs.com.

COPYRIGHT 2006 American Academy of Family Physicians

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