More vaccine, less anti-virals may be best way to treat swine fluDrugs found to provide minimal benefit to healthy adults
A new study published in the Lancet's Infections Diseases journal suggests that providing wide access to anti-viral drugs such as Tamiflu and Relenza may be less effective than extending the vaccination programme in the fight against swine flu.
The study gathered evidence about the effectiveness of the two anti-viral drugs oseltamivir and zanamivir (brand names Tamiflu and Relenza) in the treatment of seasonal flu. This was done by analysing the results from other studies into these drugs - known as a "meta-analysis".
Scientists found that in healthy adults, anti-viral drug treatment reduced the duration of flu symptoms by an average of about half a day, and for those with complications by about a day. These reductions were considered to be relatively small compared to the overall length of the symptoms in most patients, which tends to be around 4-6 days.
Although the study looked at seasonal flu, the researchers suggest that their findings may also be applicable to swine flu.
The review, lead by Dr Jane Burch and Professor Lesley Stewart of the University of York, concluded that there may be more cost-effective ways of dealing with swine flu than mass prescription of anti-viral drugs to all who ask for them.
For instance, extending the planned vaccination programme to all healthy adults rather than just those in high risk groups may be more effective overall in reducing the total effect of the swine flu outbreak.
Another concern is that widespread use of anti-virals may accelerate the evolution of the virus, leading to resistant or more dangerous strains. The scientists comment: "Any strategy that increases the availability of the drugs to the general public, consequently increasing the rates of inappropriate use, could increase the chances of viral strains developing resistance."
In conclusion, they call for further investigation into the effectiveness of alternative approaches: "Extension of the vaccination policy might be a more appropriate choice for healthy adults, and an assessment of cost-effectiveness that includes societal costs of extending the UK vaccination policy to all working-age adults seems desirable."
This article was published on Mon 10 August 2009
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