Mark Reiter, MD, Emergency Medicine, Dec 14, 2009
Emergency Physician, Bethlehem, PA
Last week, The Cochrane Review, concluded that the existing literature (they looked at 5 higher quality studies out of 20 studies of antivirals for influenza) did not support the use of neuramidase inhibitors for healthy patients for treatment of influenza. They could not detect a statistically significant clinical impact, and did not an increase in side effects, particularly nausea. (www.medscape.com/viewarticle/713604) Many physicians had come to a similar conclusion, but Cochrane's findings certainly adds significant weight.
A few days ago, the World Health Organization endorsed The Cochrane Review's findings, and recommends that antivirals only be used in influenza at high risk for complications. (www.medscape.com/viewarticle/713775) The CDC has been offering similar advice for several months.
In the week ending October 31st, 587,960 prescriptions for antiviral flu medicines were filled in the U.S. (98% for Tamiflu), according to the LA Times.
Do we really think we are helping people? Are we hurting people? Are we trying to make satisfied patients what they think they want? Are we trying to avoid complaints or lawsuits? We need to do better....
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