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Antivirals and influenza: frequency of resistance.
Pediatr Infect Dis J. 2008 Oct; 27(10 Suppl):S110-2.PI

Abstract

Antivirals are effective in prophylaxis and therapy for influenza and are likely to be active against a new pandemic variant. They can be divided into the M2 inhibitors, adamantane and rimantadine, and the neuraminidase inhibitors (NAIs), zanamivir and oseltamivir. The former are limited in activity to type A viruses, whereas the latter are also active against type B viruses. Both classes of drugs appear similarly efficacious in prophylaxis at approximately 70-90%. However, use of M2 inhibitors (adamantanes) in therapy is limited by side effects, more common with amantadine, and also by production of antiviral resistance and lack of demonstrated prevention of complications. The NAIs prevent both types of seasonal influenza, shorten duration of illness, and reduce complications. As such, their use for seasonal influenza treatment has been increasing. They are active against A(H5N1) but oseltamivir has been most extensively stockpiled because the infection in humans may be disseminated. Resistance does emerge, but not at the same frequency as with the M2 inhibitors. Resistant viruses also appear less fit and thus less able to spread. However, as use increases, resistance needs to be carefully monitored.

Authors+Show Affiliations

Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109-2025, USA. asmonto@umich.edu

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18820569

Citation

Monto, Arnold S.. "Antivirals and Influenza: Frequency of Resistance." The Pediatric Infectious Disease Journal, vol. 27, no. 10 Suppl, 2008, pp. S110-2.
Monto AS. Antivirals and influenza: frequency of resistance. Pediatr Infect Dis J. 2008;27(10 Suppl):S110-2.
Monto, A. S. (2008). Antivirals and influenza: frequency of resistance. The Pediatric Infectious Disease Journal, 27(10 Suppl), S110-2. https://doi.org/10.1097/INF.0b013e318168b739
Monto AS. Antivirals and Influenza: Frequency of Resistance. Pediatr Infect Dis J. 2008;27(10 Suppl):S110-2. PubMed PMID: 18820569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antivirals and influenza: frequency of resistance. A1 - Monto,Arnold S, PY - 2008/10/23/pubmed PY - 2008/11/19/medline PY - 2008/10/23/entrez SP - S110 EP - 2 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 27 IS - 10 Suppl N2 - Antivirals are effective in prophylaxis and therapy for influenza and are likely to be active against a new pandemic variant. They can be divided into the M2 inhibitors, adamantane and rimantadine, and the neuraminidase inhibitors (NAIs), zanamivir and oseltamivir. The former are limited in activity to type A viruses, whereas the latter are also active against type B viruses. Both classes of drugs appear similarly efficacious in prophylaxis at approximately 70-90%. However, use of M2 inhibitors (adamantanes) in therapy is limited by side effects, more common with amantadine, and also by production of antiviral resistance and lack of demonstrated prevention of complications. The NAIs prevent both types of seasonal influenza, shorten duration of illness, and reduce complications. As such, their use for seasonal influenza treatment has been increasing. They are active against A(H5N1) but oseltamivir has been most extensively stockpiled because the infection in humans may be disseminated. Resistance does emerge, but not at the same frequency as with the M2 inhibitors. Resistant viruses also appear less fit and thus less able to spread. However, as use increases, resistance needs to be carefully monitored. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/18820569/Antivirals_and_influenza:_frequency_of_resistance_ L2 - http://dx.doi.org/10.1097/INF.0b013e318168b739 DB - PRIME DP - Unbound Medicine ER -