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BMJ Analysis - Role of combination antiviral therapy in pandemic influenza and stockp
Role of combination antiviral therapy in pandemic influenza and stockpiling implications
Why stockpile ion channel inhibitors?
Combination therapy
Costs
Summary points
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http://www.bmj.com/cgi/content/extract/334/7588/293
BMJ 2007;334:293-294 (10 February), doi:10.1136/bmj.39105.428981.BE
Sotirios Tsiodras, lecturer in infectious diseases<SUP>1</SUP>, John D Mooney, public health specialist trainee<SUP>2</SUP>, Angelos Hatzakis, professor<SUP>3</SUP>
<SUP>1</SUP> Fourth Academic Department of Internal Medicine, University of Athens Medical School, Athens 12462, Greece, <SUP>2</SUP> South West Public Health Training Programme, Dorset, <SUP>3</SUP> Department of Hygiene and Epidemiology, University of Athens Medical School
It is impossible to predict which drugs will be effective against<SUP> </SUP>a new pandemic strain of influenza. Sotirios Tsiodras <SUP></SUP>and colleagues argue that failure to stockpile both major<SUP> </SUP>classes of antiviral drugs could prove costly
We currently have two classes of drugs that<SUP> </SUP>are effective against influenza viruses: the M2 ion channel<SUP> </SUP>inhibitors (amantadine and rimantadine) and the neuraminidase<SUP> </SUP>inhibitors (oseltamivir, zanamivir).<SUP>1</SUP> Although ion channel inhibitors<SUP> </SUP>are effective against several subtypes of influenza A viruses,<SUP>2</SUP><SUP> </SUP>they are not being widely stockpiled for a future influenza<SUP> </SUP>pandemic.<SUP>3</SUP> This is because they cause unacceptable side effects<SUP>1</SUP><SUP> </SUP>and their use is associated with a rapid emergence of resistance<SUP>1</SUP><SUP> </SUP><SUP>4</SUP> <SUP>5</SUP> without any demonstrable<SUP> </SUP>reduction in transmissibility or pathogenicity.<SUP>6</SUP> Resistance<SUP> </SUP>of influenza A viruses to amantadine is increasing worldwide,<SUP>7</SUP><SUP> </SUP>and the US Centers for Disease Control and Prevention recommended<SUP> </SUP>against the use of ion channel inhibitors for treatment or prophylaxis<SUP> </SUP>during the 2005-6 influenza season.<SUP>8</SUP> Policy makers and some<SUP> </SUP>medical experts thus consider ion channel inhibitors inappropriate<SUP> </SUP>as first line treatment or prophylaxis for pandemic influenza.<SUP> </SUP>We believe their role should <NOBR>. . .</NOBR> [Full text of this article]BMJ 2007;334:293-294 (10 February), doi:10.1136/bmj.39105.428981.BE
Sotirios Tsiodras, lecturer in infectious diseases<SUP>1</SUP>, John D Mooney, public health specialist trainee<SUP>2</SUP>, Angelos Hatzakis, professor<SUP>3</SUP>
<SUP>1</SUP> Fourth Academic Department of Internal Medicine, University of Athens Medical School, Athens 12462, Greece, <SUP>2</SUP> South West Public Health Training Programme, Dorset, <SUP>3</SUP> Department of Hygiene and Epidemiology, University of Athens Medical School
It is impossible to predict which drugs will be effective against<SUP> </SUP>a new pandemic strain of influenza. Sotirios Tsiodras <SUP></SUP>and colleagues argue that failure to stockpile both major<SUP> </SUP>classes of antiviral drugs could prove costly
Why stockpile ion channel inhibitors?
Summary points
<!--References
--><!-- null -->
<DL><DT>Bird flu and transparency </DT><DD>Fiona Godlee
BMJ 2007 334: 0. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>The next best thing </DT><DD>Douglas Kamerow
BMJ 2007 334: 0. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>Preparing for the next flu pandemic </DT><DD>Wei Shen Lim, Anne Thomson, and Paul Little
BMJ 2007 334: 268-269. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>People exposed to H5N1 in English turkey outbreak get antiviral and vaccination </DT><DD>Susan Mayor
BMJ 2007 334: 275. <NOBR>[Extract] [Full Text] </NOBR></DD></DL>