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TUESDAY, March 18, 2014 (HealthDay News) -- The antiviral drug Tamiflu reduced the risk of death by 25 percent among adults hospitalized during the 2009 H1N1 swine flu pandemic, according to a new review.
Also, antiviral treatment within 48 hours of developing flu symptoms halved the risk of death compared with starting treatment later or receiving no treatment, according to the study, which was published March 18 in the journal The Lancet Respiratory Medicine.
The risk of death rose by about 20 percent for every 24 hours that treatment was delayed after 48 hours since the start of symptoms, the researchers also found.
"As expected, early treatment seems to be optimal, and treatment shouldn't be delayed by even one day to wait for diagnostic test results," Alicia Fry, of the U.S. Centers for Disease Control and Prevention, wrote in an accompanying journal editorial. "However, if the patient presents for care more than two days after illness onset, treatment might still have some benefit, especially if they are severely ill."
Although treatment with Tamiflu (oseltamivir) reduced the risk of death in many groups of adults -- including pregnant women and severely ill patients -- it didn't significantly reduce death risk among children.
The researchers analyzed data from 78 studies that included more than 29,000 patients of all ages in 38 countries who were hospitalized with confirmed or suspected H1N1 infection between Jan. 2, 2009, and March 14, 2011.
Study lead author Professor Jonathan Nguyen-Van-Tam, of the University of Nottingham, in England, said many governments have stockpiles of Tamiflu approaching its expiration date. "But until now," Nguyen-Van-Tam said, "they had no adequate data to assist them in deciding if lives were saved in 2009 and 2010 or not, and whether they should replenish or not."
"The situation is made more complex by the fact that when an influenza pandemic occurs, even with the best will in the world, vaccine arrives six months too late and its public-health benefit is therefore moderate at best," he said. "Thus we are left with antivirals like Tamiflu and public-health measures like handwashing and social distancing as the only defenses we have for the first six months of a pandemic."
Even though the review found that Tamiflu did not appear to reduce children's risk of death, Fry said the potential benefit of treatment with the drug "for severely ill children is substantial and outweighs any potential risk associated with treatment."
-- Robert Preidt
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SOURCE: The Lancet Respiratory Medicine, news release, March 18, 2014