[What is current opinion of antiviral therapy for the flu in 2001?].
BACKGROUND
The availability of new neuraminidase inhibitors which interact on the influenza A and B viruses could be the start of a new approach to flu treatment. Until now, vaccination has been the principal medical treatment, except in the case of a pandemic caused by antigenic shifts. In this article the authors will answer the following questions: Potentially, is there room for antiviral drugs and why? Are these drugs efficient and according to which criteria? Who are they for? And what indications must be followed? Are they well tolerated? Do they induce any viral resistance? M2 protein inhibitors (i.e., amantadine and rimantadine) are compared with neuraminidase inhibitors (i.e., zanamivir and oseltamivir).


BACKGROUND
Neuraminidase inhibitors prescribed during the first 48 h have a medical curative effectiveness on non-complicated forms carried by healthy patients--symptoms last no longer than 1 to 3 days and their severity is reduced. This efficiency could potentially concern unexpected complications due to the diminution of antibiotics absorption. The inhibitors seem to induce little resistance and are responsive to influenza B as opposed to the M2 protein inhibitors. They seem to be well-tolerated by patients and they are also efficient when it comes to prophylaxis measures.


CONCLUSIONS
It is assumed that these treatments are used in a curative and preventive manner in order to give them their full strategic importance (their use is currently forbidden in France). This importance will require that physicians and the population be well aware of the epidemic and that responsive physicians who know the medical indications quickly implement the treatment. It is necessary to carry out surveys with those at risk who are seriously ill with the flu in order to measure ratios such as cost efficiency. The use of these treatments will have to be evaluated, bearing special attention on the risks of the emergence of resistant viruses and on the impact on vaccination.
Gaillat
J
J
Service de médecine interne et des maladies infectieuses, centre hospitalier de la région annécienne, 74011 Annecy, France. smi.jgaillat@ch-annecy.fr
D000998:Antiviral Agents / Q000627:therapeutic use*; D004351:Drug Resistance; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000188:drug therapy*
D000998:Antiviral Agents; D007252:Influenza Vaccines
Que penser du traitement antiviral de la grippe en l'an 2001?