Concerted Effort Needed to Fight Drug-Resistant Flu Strain

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Some of the candidates are years away. But some, including Relenza (zanamivir), a cousin of Tamiflu, is already available, and another, peramivir, is in Phase 3 trials and close to being released, said Dr. Christine M. Hay, an assistant professor of infectious diseases at the University of Rochester Medical Center.

A multi-drug strategy is likely to be the most effective, Moscona stated, as resistance of virus strains to specific drugs becomes increasingly common.

Current drugs and others in the pipeline should be employed, Moscona wrote. These include:

• Giving Relenza intravenously. Relenza is a drug in the same class as Tamiflu, but has not yet seen resistance.
• Peramivir, an experimental neuraminidase inhibitor, is expected to be available intravenously as well as with a shot. Neuraminidase inhibitors are antiviral drugs that block a specific protein on the flu virus.
• Long-acting inhaled neuraminidase inhibitors, which are, again, not yet licensed, but could be used in one dose as a treatment or once a week for prevention of the flu. "It's not clear how useful this is going to be over what's already there," Hay said. "It's just going to act longer."

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The encouraging news about the recent emergence of resistance to Tamiflu, the JAMA article noted, is that the resistant strain of flu is no more virulent than the "normal" strain.

H1N1 is the most common type of flu circulating in the United States. Also, the other two strains appear not resistant, and three other drugs available to fight the flu are still effective.

And as always, the best prevention against the flu is to be vaccinated, health officials emphasized.

"The first thing anybody should do always is to use the vaccine," said John M. Quarles, head and professor of microbial and molecular pathogenesis at Texas A&M Health Science Center College of Medicine. "That's the first line of defense."

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the seasonal flu.

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