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Tamiflu shows no effect on duration of viral shedding
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Tamiflu was associated with a shorter duration of influenza symptoms, but the drug did not affect duration of viral shedding or the risk for household transmission, according to researchers from Harvard School of Public Health and Li Ka Shing Faculty of Medicine at the University of Hong Kong.
“Although existing guidelines do not recommend the prescription of oseltamivir for outpatients without risk factors for progression to more severe disease, our results demonstrate benefits on outpatient use in terms of faster self-reported symptom alleviation,” the researchers wrote in the Journal of Infectious Diseases.
The researchers evaluated data from a study on household transmission of influenza conducted from 2008 to 2013. Patients were recruited from outpatient clinics if they had at least two symptoms of acute respiratory illness that developed within 48 hours of recruitment, no acute respiratory illness 14 days before recruitment, and if they lived with at least two individuals who did not have acute illnesses in the prior 14 days.
Nasal and throat specimens were collected from the index patients at baseline and at subsequent visits over 7 to 10 days. Specimens also were collected from the household contacts. The index patients and household contacts recorded symptoms daily and monitored body temperatures. The researchers obtained data on the prescription of Tamiflu (oseltamivir, Genentech).
Among the 4,301 index patients recruited, 876 had positive rapid tests, and 582 were included in the analysis. Patients initiating oseltamivir within 24 hours of symptom onset experienced a 56% reduction in time to cessation of all influenza symptoms, a 47% reduction in time to fever alleviation and a 56% reduction in time to cessation of respiratory symptoms, compared with patients not receiving oseltamivir. There was no difference in the duration of viral shedding.
Index patients with household contacts who had viral shedding detected at the initial home visit were excluded from the analysis. Among the remaining 467 households analyzed, 139 out of 1,420 household contacts had confirmed influenza. However, there was no association between oseltamivir and the infectivity of the index patient. – by Emily Shafer
Disclosure: Cheung reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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