Science-based clinic
December 2024
A new study published in Clinical Infectious Diseases examines the use of antiviral treatments in hospitalized children with laboratory-confirmed influenza. The findings underscore the importance of timely antiviral therapy and adherence to national medical guidelines. According to the study, approximately half of the children hospitalized with influenza did not receive antiviral treatment.
Lead author James Antoon expressed concern, stating, "Our findings of limited use of antivirals in hospitalized children with influenza illness is concerning."
Among the children who did receive antiviral therapy, 650 out of 652 were treated with oseltamivir, accounting for approximately 99.7% of antiviral use.
And what we know on the efficacy of oseltamivir?
The Cochrane Collaboration reviewed the effectiveness of oseltamivir (Tamiflu) and found mixed and critical results. Their detailed analyses raised doubts about the drug's claimed benefits, especially regarding its ability to prevent serious complications of influenza, such as pneumonia, or reduce hospitalizations and mortality rates.
Key conclusions include:
Oseltamivir was found to reduce the duration of flu symptoms by about half a day in adults and children, but this effect was relatively modest given the costs and risks associated with the drug.
The review concluded there was no clear evidence that oseltamivir reduces serious complications like pneumonia or hospitalizations. Regulatory bodies, including the FDA and others, similarly noted a lack of evidence supporting these claims.
The review highlighted that oseltamivir is associated with an increased risk of nausea, vomiting, and other adverse effects, raising concerns about its risk-benefit ratio.
The Cochrane team faced significant difficulties obtaining access to complete clinical trial data from Roche, the drug's manufacturer. Once full clinical study reports were analyzed, they found discrepancies between published and unpublished data, which undermined trust in earlier findings favoring the drug.
Overall, the Cochrane review concluded that while oseltamivir may have some benefits in reducing flu symptoms, its effectiveness in preventing complications and its role in public health policies remain questionable. The findings emphasized the need for greater transparency in clinical trial data to ensure reliable evaluations of drug effectiveness.
This may help explain the low rate of antiviral drug use in children with influenza.
Nati Elkin
