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Routine Use of Flu Drugs Discouraged
Jan. 18, 2006 - Flu drugs aren't a magic bullet against seasonal flu -- much less a feared bird flu pandemic, warns a controversial new study.
The study is a new look at all existing data on flu drugs. There are four of these drugs: the older ones, Symmetrel and Flumadine, and the newer ones, Tamiflu and Relenza.
The study concludes that it's time to retire the old-generation drugs. It tells doctors to discourage their use. That's not a surprise, given that new-generation drugs are considered far more effective than the old ones.
What is a surprise is what researcher Tom Jefferson, MD, and colleagues say about Tamiflu and Relenza. They warn against using these drugs during normal flu seasons and say that doctors should prescribe the drugs only in the event of a severe epidemic of seasonal flu or a pandemic flu outbreak.
"People should be aware of these drugs' limitations. They are not a panacea," Jefferson tells WebMD. "[Tamiflu and Relenza] don't prevent flu infection. They do prevent symptoms of [actual] flu but they do not prevent influenza-like illness [caused by other viruses]. They appear to decrease hospitalization and more serious complications of flu. They diminish -- but don't suppress -- nasal secretion of infectious virus."
The study appears in the Jan. 19 online issue of The Lancet.
When to Take Flu Drugs -- and When Not To
Tamiflu and Relenza do work, Jefferson says. But he worries about two things:
- If people routinely take these drugs whenever they have a flu-like illness, flu viruses will soon become resistant and the drugs won't work when we really need them.
- People who take the drugs during flu epidemics will become overconfident and contribute to the spread of the epidemic by ignoring public health measures such as staying home, washing their hands, coughing into tissues, etc.
Doctors should never prescribe flu drugs simply because patients complain of flu-like symptoms, says flu expert John Treanor, MD, professor of medicine and director of the vaccine and treatment evaluation unit at the University of Rochester in New York.
"We would only recommend flu drugs to treat flu. They clearly have no activity against other viruses. That always has been obvious," Treanor tells WebMD. "The concern that people would use them inappropriately is why these drugs are not available over the counter in the U.S."
Treanor sees no reason not to give flu drugs to someone who tests positive for flu. Neither does flu treatment expert Anne Moscona, MD, professor of pediatrics and of microbiology and immunology, and vice chairwoman of pediatrics research at Weill Medical College of Cornell University in New York.
"I feel that flu is not a mild illness," Moscona tells WebMD. "It is not possible to predict who will become severely ill with flu."
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