The antiviral drugs Tamiflu and Relenza can shorten the duration of seasonal influenza by as much as a day and a half, but they have little or no effect on complications, including ear infections and the need for antibiotics, British researchers report today in the British Medical Journal. Tamiflu also led to an increased risk of vomiting. The studies reviewed in the article looked only at seasonal flu, but researchers think that the findings are most likely applicable to pandemic H1N1 flu as well.
They also concluded that giving the drugs to children after they have been exposed to the flu virus -- post-exposure prophylaxis -- reduces transmission by only 8%. That means that 13 children have to be given the drugs to block one new case.
The researchers from Oxford University studied four separate randomized trials (two with Tamiflu and two with Relenza) that treated 1,766 children with the flu and three trials of post-exposure prophylaxis involving 863 children -- all involving seasonal flu. They concluded that, despite shortening the duration of infection, the drugs did not reduce the normal complications of flu, including asthma flareups, ear infections, sinusitis, bronchitis and convulsions from fever. "There is currently no evidence to single out special treatment for children with asthma," they wrote. Because pandemic influenza symptoms in children have so far been mild, they added, physicians probably should be more conservative in using the drugs.
-- Thomas H. Maugh II