Zanamivir: a second look. Still no tangible impact on influenza

(1) The reference treatment for suspected influenza during outbreaks is simple relief of symptoms (fever, rhinitis, headache, myalgia, etc.). (2) According to a comparative placebo-controlled trial involving 525 patients with asthma and/or chronic obstructive airways disease, and a meta-analysis of 9 trials involving patients at risk of complications, zanamivir shortens the duration of symptoms of suspected influenza by about a day. But zanamivir has not been shown to reduce antibiotic prescribing, or the incidence of complications necessitating hospitalisation. (3) Zanamivir has no proven efficacy in preventing the spread of influenza by a treated patient. (4) Zanamivir inhalation can induce bronchospasm. (5) In practice, prevention through vaccination remains the mainstay of management. Symptomatic relief is the only rational therapy for influenza.