Editor—Experts question the wisdom of stockpiling oseltamivir (Tamiflu).1 A question was asked about data supporting an improvement in mortality with the drug.
Two datasets were presented at the second European Influenza Conference in Malta (www.eswi.org) in September. A large retrospective cohort study of patients with influenza-like illness (n = 176 001) taken from a US health database showed that oseltamivir (75 mg twice daily, n = 39 202) significantly reduced the risks of pneumonia by 32% (P < 0.001) and of death by 91% (P < 0.05) (Nordstrom et al). In Canadian patients with laboratory-confirmed influenza (A or B) requiring hospital admission (< 15- > 64 years; n = 359), oseltamivir reduced the risk of death by 68% (McGeer et al). Treatment with oseltamivir therefore statistically and meaningfully reduces the risk of death in patients of all ages and from all walks of life, infected with influenza A or B.
The news item also reported that oseltamivir does not prevent infection with the flu virus, and that at best it would reduce the severity of illness. On the basis of data from clinical trials, oseltamivir was approved by the European Medicines Agency (EMEA) for preventing flu in adults and adolescents aged ≥ 13. Additionally, a recent large scale study examined the effectiveness of oseltamivir (75 mg once daily) in protecting family members who had come into contact with a person infected with flu: oseltamivir protected around 80% of contacts from flu infection.2
Furthermore, although oseltamivir has certainly been proved to reduce the duration of illness by ≤ three days, it also reduces the risk of admission, bronchitis, pneumonia, and related antibiotic use associated with flu.3
Competing interests: JRS and RD are employees of Roche, which manufactures Tamiflu (oseltamivir).
References
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