Review: antiviral agents reduce risk of influenza in healthy adults and alleviate symptoms faster than placebo

摘要

Influenza and ILI are major causes of morbidity and mortality, with implications for healthcare and societal costs. Recent planning for a pandemic has led to efforts to increase vaccination coverage and stimulated interest in antiviral medications. Using the rigorous methodology of systematic review, Jefferson ef al compiled the growing body of evidence, which can be confusing because of the use of anti-influenza drugs for either prophylaxis or treatment. The results show that antiviral drugs reduce symptoms of true influenza but are much less or not effective for ILI, which is also caused by other types of viruses. In an average influenza season, only 10-18% of cases with specimens sent for testing are confirmed as true influenza.1 Until rapid testing for influenza is more widely available and reliable, routine use of antiviral medications for all patients is not justified. Less expensive, equally effective options, with fewer adverse effects, are available for symptom relief (eg, antipyretics and decongestants). A key finding was that none of the drugs reduced the risk of asymptomatic infection or completely eliminated viral shedding. Influenza is spread through contact with infected droplets of respiratory secretions. Treating asymptomatic carriers who continue their usual activities may, therefore, increase the risk of infecting others, rather than reducing it.Antiviral drugs do have a role in the management of influenza (eg, in patients who are older or younger than the age range studied or who have comorbid diseases that increase their risk of complications from influenza). However, the recommendation by Jefferson ef al against the routine use of antiviral agents for influenza is justified. Improved vaccination coverage, frequent hand washing, cough etiquette, and staying home when ill are more reliable strategies for reducing incidence of influenza and ILI.