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Antiviral agents in flu prevention:
possibly in addition to vaccination in some cases

Vaccination is the prophylaxis against flu. Antiviral agents could possibly be prescribed as well when there is a very high risk of complications in those whose health is fragile.

Flu is a frequent acute respiratory infection with complications that affect mainly those who are fragile: the elderly, or children suffering from serious congenital anomalies, for example. Flu prevention relies chiefly upon vaccination. In the over-65 age group, flu vaccination can reduce deaths by around 80%, and the number of flu-related hospitalisations and cases of pneumonia by 50%.

In France, three antiviral agents against flu are available: amantadine, zanamivir and oseltamivir. They are not very effective preventatives and they have significant adverse effects. There is no justification for using an antiviral agent as prophylaxis in healthy adults and children. Despite the absence of convincing data as to the efficacy of oseltamivir as a preventive against flu complications, its effect on confirmed flu causes it to be prescribed to people presenting a high risk of serious complications, when there is a strong likelihood they will catch the flu and they have not yet been vaccinated. In such cases, the other preventive measures remain valid: immediate vaccination, quarantining those with flu, wearing a mask, washing hands.

©Prescrire October 2005

Source: "Les antiviraux dans la grippe : un complément à la vaccination, dans certains cas" Rev Prescrire 2005 ; 25 (265) : 678-691.

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