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Debate Regarding Oseltamivir Use for Seasonal and Pandemic Influenza

机译：关于奥司他韦用于季节性和大流行性流感的辩论

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A debate about the market-leading influenza antiviral medication, oseltamivir, which initially focused on treatment for generally mild illness, has been expanded to question the wisdom of stockpiling for use in future influenza pandemics. Although randomized controlled trial evidence confirms that oseltamivir will reduce symptom duration by 17–25 hours among otherwise healthy adolescents and adults with community-managed disease, no randomized controlled trials have examined the effectiveness of oseltamivir against more serious outcomes. Observational studies, although criticized on methodologic grounds, suggest that oseltamivir given early can reduce the risk for death by half among persons hospitalized with confirmed infection caused by influenza A(H1N1)pdm09 and influenza A(H5N1) viruses. However, available randomized controlled trial data may not be able to capture the effect of oseltamivir use among hospitalized patients with severe disease. We assert that data on outpatients with relatively mild disease should not form the basis for policies on the management of more severe disease.
机译：关于市场领先的抗流感抗病毒药物奥司他韦的争论最初集中在一般轻度疾病的治疗上，现在已经扩大了人们对储存用于未来流感大流行的智慧的质疑。尽管随机对照试验证据证实了奥司他韦可以使健康的青少年和社区管理疾病的成年人减少症状持续时间17-25小时，但尚无随机对照试验检查过奥司他韦对更严重结果的有效性。观察性研究尽管在方法论上受到批评，但建议在确诊由甲型H1N1流感病毒pdm09和甲型H5N1流感病毒感染的住院患者中，尽早服用奥司他韦可以将死亡风险降低一半。但是，可用的随机对照试验数据可能无法反映奥司他韦在住院的重症患者中的作用。我们认为，有关轻度疾病门诊患者的数据不应成为管理更严重疾病的政策的基础。

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