Antivirals for influenza: Where now for clinical practice and pandemic preparedness?

摘要

Amid intense media coverage in April, 2014, the Cochrane Collaboration published an updated systematic review on the efficacy of neuraminidase inhibitors for influenza.1 Jefferson and colleagues1 identified 107 clinical study reports (CSRs) of published and unpublished randomised clinical trials (RCTs). Of these, less than half were included in the meta-analysis, which concluded that in adults oseltamivir reduced time to first alleviation of symptoms of influenza-like illness by 16-8 h (95% Cl 8-4-25-1; p<0-0001). In otherwise healthy children oseltamivir reduced illness by 29 h (12-47; p=0-001), but benefit was not evident in asthmatic children. Zanamivir reduced symptom duration in adults by 0-60 days (O-39-O-81; p<000001), but it had no significant effect in children. For serious influenza-related complications or those leading to study withdrawal, and radiologically verified pneumonia, the accessed data did not reveal significant effects with either drug.