December 2009. Volume 5. Number 4

There are doubts about the clinical relevance of the neuraminidase inhibitors' therapeutic effect in the seasonal flu in children

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Shun-Shin M, Thompson M, Heneghan C, Perera P. Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials. BMJ. 2009;339:b3172. doi:10.1136/bmj.b3172
Reviewers: Andrés de Llano JM1, Ochoa Sangrador C2.
1Servicio de Pediatría. Hospital General del Río Carrión. Palencia. España.
2Servicio de Pediatría. Hospital Virgen de la Concha. Zamora. España.
Correspondence: Jesús María Andrés de Llano. Email: jmandres@ono.com
Reception date: 05/11/2009
Acceptance date: 11/11/2009
Publication date: 10/12/2009

Abstract

Authors' conclusions: neuraminidase inhibitors provide a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission. They have little effect on asthma exacerbations or the use of antibiotics. Their effects on the incidence of serious complications and on the current A/H1N1 influenza strain remain to be determined.

Reviewers' commentary: the studies suggest that the neuraminidase inhibitors shorten the duration of symptoms usually between 0.5 and 1.5 days, being smaller the effect among the cases of clinical flu. There exist doubts on the clinical importance of the effect. The studies show homogeneous results for prevention with a reduction of 8% in the transmission of the flu; being the number needed to treat of 13 to prevent one additional household case of symptomatic influenza. Although at the present day the effect of the antiviral agents in reducing the disease or in preventing the complications for the new pandemic flu is unknown, the current evidence suggests that the potential benefit is limited and it seems reasonable to apply a restricted use of the neuraminidase inhibitors, valuing individually for each patient the risk level, the severity of the condition and the likelihood of the diagnosis.

How to cite this article

Andrés de Llano JM, Ochoa Sangrador C. Existen dudas sobre la importancia clínica del efecto terapéutico de los inhibidores de la neuraminidasa en la gripe estacional en niños. Evid Pediatr. 2009;5:78.

AVC | Critically appraised articles

Shun-Shin M, Thompson M, Heneghan C, Perera P. Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials. BMJ. 2009;339:b3172. doi:10.1136/bmj.b3172
Reviewers: Andrés de Llano JM1, Ochoa Sangrador C2.
1Servicio de Pediatría. Hospital General del Río Carrión. Palencia. España.
2Servicio de Pediatría. Hospital Virgen de la Concha. Zamora. España.
Correspondence: Jesús María Andrés de Llano. Email: jmandres@ono.com
Reception date: 05/11/2009
Acceptance date: 11/11/2009
Publication date: 10/12/2009

How to cite this article

Andrés de Llano JM, Ochoa Sangrador C. Existen dudas sobre la importancia clínica del efecto terapéutico de los inhibidores de la neuraminidasa en la gripe estacional en niños. Evid Pediatr. 2009;5:78.

References

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  2. Hedrick JA, Barzilai A, Behre U, Henderson FW, Hammond J, Reilly L, et al. Zanamivir for treatment of symptomatic influenza A and B infection in children five to twelve years of age: a randomized controlled trial. Pediatr Infect Dis J 2000;19:410–7.
  3. Whitley RJ, Hayden FG, Reisinger KS, Young N, Dutkowski R, Ipe D, et al. Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J. 2001;20:127–33.
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10/12/2009

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