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Swine flu drugs' should be held back for the young'

By Lilian Anekwe

Antiviral treatment should be reserved for the young and under 65s during the swine flu pandemic, according to new research out today.

A model of the transmission of the influenza virus during the 1918 flu pandemic suggests that providing the elderly with antiviral drugs would not significantly reduce mortality – and may lead to an increase in resistance.

Antivirals are currently given out to all patients who are diagnosed with swine flu, either by their GP or by the newly-established National Pandemic Flu Service, unless there is a specific contraindication.

Dr Stefano Merler, director of the Bruno Kessler Foundation, an Italian research organization, argues his research shows reserving antivirals for the under-65s would reduce morbidity and excess mortality.

Dr Merler modelled the effects of flu outbreaks and the efficacy of different age-prioritised strategies for the use of antivirals for both treatment of swine flu and post-exposure prophylaxis.

The study, published in the journal BMC Infectious Diseases, found that, depending on the behaviour of the virus, treatment of over 65s may not lead to any significant reduction in the cumulative number of cases.

He concluded: ‘It is too early to confidently predict some important features of the ongoing influenza pandemic, [but] the use of antivirals is confirmed to be the most effective single intervention, in the absence of vaccines.

‘Although a policy of age-specific prioritisation of antiviral use will be controversial ethically, it may be the most efficient use of stockpiled therapies.'

The researchers also stressed that antiviral drugs for prophylaxis should also be provided to high-risk GPs and healthcare workers and emergency services personnel for the duration of the pandemic outbreak.

The DH has substantial Tamiflu stockpiles

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