Have we been guilty of over-estimating the ability of anti-flu drugs to prevent illness and infection? A recent systematic review of 53 randomised controlled trials has revealed various shortcomings of available agents.
The M2 ion-channel blocking drugs amantadine and rimantadine had a mainly symptomatic effect on influenza virus infections; however, they did not prevent infection or nasal shedding. The reviewers said their use should be discouraged.
The neuraminidase inhibitors oseltamivir and zanamivir were also useful symptomatically. They also did not appear to prevent asymptomatic infection; however, they did decrease nasal shedding, possibly interrupting viral transmission in households. Because of this relatively low effectiveness, the reviewers advised against the use of neuraminidase inhibitors in seasonal influenza control; they said these agents should only be used in serious epidemics or pandemics — together with other public health measures.
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