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A new analysis of existing literature in Annals of Internal Medicine suggests patients prescribed antivirals for nonsevere influenza infections have no reduction in risk of hospital admission or mortality. There is some evidence, however, that antivirals can reduce symptom duration.
Included in the analysis were 73 randomized control trials, of which 40 reviewed oseltamivir (Tamiflu).
Across all studies, influenza-related mortality or hospital admission was rare, seen in less than 2 and 21 patients per 1,000, respectively. No antiviral reduced the risk of these events.
Time to symptom resolution, however, dropped in patients taking antivirals, but the effect was small: 0.75 days in oseltamivir groups, and 1.02 days in patients treated with baloxavir (Xofluza).
More resistance seen with Xofluza
Also of note, trials with oseltamivir had more treatment-related adverse events (AEs) than standard care or placebo. The antiviral baloxavir did not increase treatment-related AEs, but resistance developed in 9.97% of those treated.
Influenza vaccinations must remain the first line of defense.
In an attached commentary on the analysis by researchers at the Mayo Clinic, the authors write, “Baloxavir is probably more effective and better tolerated than other available anti-viral drugs but should not be expected to reduce influenza-related hospitalization or death. Influenza vaccinations must remain the first line of defense.”