The Pharmaceutical Journal
Vol 270 No 7230 p6
4 January 2003

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Use Tamiflu for prevention not treatment of 'flu, says DTB

OSELTAMIVIR (Tamiflu), a new oral influenza drug, should be used for the prevention of influenza, in addition to vaccination, but not treatment, according to Drug and Therapeutics Bulletin.

Reviewing oseltamivir in its December issue, the DTB says that while vaccination against influenza offers 70–80 per cent protection, outbreaks can still occur in vaccinated people due to changes in surface antigens on circulating strains of the virus.

The use of oseltamivir for preventing influenza has been studied in three large trials, but these tended to exclude patients who might be most at risk of complications from an infection. One trial, in 548 elderly nursing home residents, most of whom had been vaccinated, found that 75mg of oseltamivir once daily for six weeks after an influenza outbreak at or near the home, reduced the incidence of infection by 91 per cent.

Studies of the drug for treating acute influenza-like illness found that 75mg twice daily reduced the duration of the illness by around one day. "Annual vaccination is the cornerstone of prophylaxis for all those at risk from influenza and its complications," the DTB concludes. However, should an outbreak of influenza occur in nursing homes or similar institutions, prophylactic treatment of both residents and staff with oseltamivir would be reasonable, it adds (2002;40:89).