Antivirals for pandemic influenza

Following the June 2009 H1N1 influenza outbreak, the World Health Organization declared it a global pandemic, and H1N1 continues to spread around the world.4 In Canada, amantadine and the neuraminidase inhibitors are available for the prophylaxis and treatment of influenza. [...] As well, a similar comparison was done for early administration of antiviral treatments.14 The World Health Organization (WHO) carried out a systematic review on the pharmacological management, including treatment and prophylaxis, of pandemic influenza A (H1N1) 2009 and other influenza viruses to inform the recommendations process.20 Eleven studies of the effectiveness of antiviral treatments for [...] The only drug mentioned in some of the studies was oseltamivir.20 The WHO review also included two surveys of treatment adherence and adverse events on the prophylactic use of oseltamivir for H1N1 influenza in the United Kingdom.20 One report by Wallensten et al. [...] For instance, 48% of the primary school children completed the full course and 76% of the secondary school children took the full-course of oseltamivir prophylaxis. [...] Two patients died on the twentieth day of illness.21 According to their observations, the authors suggested that the recommended dose and duration of oseltamivir treatment may not completely suppress the viral replication, which may lead to the development of drug resistance.21 As well, the authors noted that treatment with oseltamivir late in the course of influenza H5N1 may not be clinically eff