SELECTED ARTICLES FROM THE RECENT LITERATURE 2003

12/22/03

Does oseltamivir reduce complications of influenza infection?

Summary
There has been widespread concern about a rapidly spreading occurrence of influenza (Flu) infection in the USA starting in November 2003. The supply of the traditional inactivated Flu vaccine has been running low. Therefore, it is of particular interest to learn how effective any pharmacotherapy for Flu infections would be. Previous treatment with agents such as amantidine were only modestly effective and/or had significant side effects. More recently, an unrelated agent, oseltamivir (Osel) has been used to treat Flu infections. Kaiser et al of the Hopital Cantonal in Geneva, Switzerland investigated the efficacy of Osel compared to placebo in 3,564 patients with Flu-like illnesses. Among adults and adolescents who had proven Flu infection, Osel treatment was associated with a 55% reduction in the incidence of complicating bronchitis (4.6% vs 10.3%; p<0.001). There was an overall reduction of antibiotic use in the Osel-treated patients. In those considered to be at a high risk for Flu complications, Osel therapy was associated with a 34% reduction in the incidence of lower respiratory tract complications (p=0.02).

Reference
Arch Intern Med 2003;163:1667-72

Editor's Comments
These findings suggest that Osel administration starting close to the onset of Flu-like illnesses may not prevent further Flu infection but does seem to decrease the frequency of complications that may lead to severe morbidity or even mortality. This effect of Osel does not appear to be non-specific since Osel treatment had no beneficial effects when given to patients who turned out to not have culture-proven Flu infection.

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