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Friday, 11 April 2014

Influenza antiviral debate - is there a benefit? or "take a pill already"

This week saw the release of an updated review of influenza antiviral therapy and suggesting that such drugs have limited value.

The following are two reviews, sent by different individuals, which challenge or affirm the media interpretation of the documents.   Both are worth reading and provide that deeper level of insight that readers should seek when faced with trying to figure out what such in-depth documents proport to say, then are abstracted by a communications person seeking media attention, who then read the abstract, perhaps the summary, and seek opposing positions so as to give the sense of “balanced” journalism, Anti-antiviral stance  and  Science based medicine review

Those wanting to dig deeper should scan or read the full review Cochrane review.  Notable is the filtering inserted as the full review is abstracted  and then subjected to public relations conversion to lay language.

Having said that, oseltamivir and its siblings were not approved as a panacea, nor did they claim more than about a 10% reduction in symptom duration.  Guidelines for their use in Canada recommend use in those at high risk, and acknowledge that those wishing to reduce symptom duration may benefit.  Canadian antiviral guidance.   It must also be acknowledged that several contributors to the Canadian guidelines have stated potential conflicts of interest, which does not mean their opinions are biased, only that objectivity may be affected.

The Canadian guidelines are rationale and reasoned, and focus on annual influenza strains.  Given a novel strain, significantly underlying medical condition, or developing severity, influenza antivirals have a place and will likely remain as an emergency stock as the best available option for preventing death and complications.  

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