Antivirals May Not Affect Children's Flu Complications

But the neuraminidase inhibitors are shown to shorten disease duration in children

MONDAY, Aug. 10 (HealthDay News) -- The neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza) may have little or no effect on various complications in children with seasonal influenza, according to a study published online Aug. 10 in BMJ.

Matthew Shun-Shin, of John Radcliffe Hospital in Oxford, U.K., and colleagues performed a systematic review and meta-analysis of data from randomized controlled trials that took place up to June 2009. They included four randomized trials of treatment of influenza (two with oseltamivir, two with zanamivir) involving 1,766 children and three randomized trials on post-exposure prophylaxis (one with oseltamivir, two with zanamivir) involving 863 children.

The trials showed reductions (0.5 to 1.5 days) in median time to resolution of symptoms, return to normal activities or both, although they were significant in only two trials. A 10-day course of post-exposure prophylaxis that used either drug resulted in an 8 percent decrease in the incidence of symptomatic influenza. One trial showed that oseltamivir did not improve peak flow in asthmatic children or reduce asthma exacerbations. Treatment was also not associated with a reduction in the use of antibiotics. Oseltamivir was associated with an increased risk of vomiting, though zanamivir was well-tolerated.

"Neuraminidase inhibitors provide a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission," the authors write. "They have little effect on asthma exacerbations or the use of antibiotics. Their effects on the incidence of serious complications, and on the current A/H1N1 influenza strain remain to be determined."

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Andrea Mongler

Andrea Mongler

Updated on August 11, 2009

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