Colds and the Flu - Medications

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The current use of neuraminidase inhibitors in different age and patient groups is as follows:

• Adults: Both drugs are approved for treatment in adult patients.
• Children: Oseltamivir is approved for use in children age one and older. Studies report significant reduction in symptoms and in the incidence of ear infections in this population. The American Academy of Pediatrics recommends the following: Therapy should be provided to children with influenza infection who are at high risk of severe infection, and to children with moderate-to-severe influenza infection who may benefit from a decrease in the duration of symptoms. Prophylaxis should be provided (1) to high-risk children who have not yet received immunization and during the 2 weeks after immunization, (2) to unimmunized family members and health care professionals with close contact with high-risk unimmunized children or infants who are younger than 6 months, and (3) for control of influenza outbreaks in unimmunized staff and children in an institutional setting.
• High-risk Patients. Recent studies indicate neuraminidase inhibitors are safe and effective in patients with serious medical problems or other conditions that put them at risk for complications of flu.

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A third neuroaminidase product, peramivir, is now in clinical trials. However, it was authorized as emergency treatment for severely ill, hospitalized patients with H1N1 "swine" flu. This authorization was terminated in June 2010. Peramivir is given intravenously.

Anti-Viral Drugs: M2 Inhibitors

Brands and Benefits. Amantadine (Symmetrel) and rimantadine (Flumadine) are M2 inhibitors. The following benefits may apply to the minority of strains of influenza A that remain sensitive to the drugs:

• Both offer some protection against influenza A and prevent severe illness if a person contracts the infection. (To be effective, it must be administered within 2 days of onset.)
• They may shorten the duration and lessen the severity of the flu if given within 48 hours of onset of symptoms.