April 3, 2012Annals of Internal Medicine
Antivirals for Treatment of Influenza
Authors
Discussion
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Implication
Systematic review shows antiviral therapy reduces mortality and hospitalizations in high-risk influenza patients, indicating potential net clinical benefit despite low-quality evidence.
Key Points
- To systematically review observational evidence evaluating the benefits and harms of oseltamivir, zanamivir, amantadine, and rimantadine for influenza treatment.
- Searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and four other databases through November 2010 for observational studies evaluating single antiviral therapy against no therapy or other antivirals.
- Identified 74 eligible studies and assessed effect estimate confidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
- In high-risk patients, oral oseltamivir significantly reduced mortality (OR, 0.23 [95% CI, 0.13 to 0.43]; low-quality evidence), hospitalizations (OR, 0.75 [95% CI, 0.66 to 0.89]; low-quality evidence), and symptom duration by 33 hours (95% CI, 21 to 45 hours).
- Inhaled zanamivir reduced symptom duration by 23 hours (95% CI, 17 to 28 hours; moderate-quality evidence) and hospitalizations (OR, 0.66 [95% CI, 0.37 to 1.18]), while direct comparisons between oseltamivir and zanamivir revealed no important differences.
Cite This Study
Hsu et al. (2012) studied this question.