[Rimantadine in the prevention and treatment of influenza A]

Although the antiviral properties of rimantadine specifically directed against influenza A viruses have been known for more than 25 years, this compound has not been widely used owing to its narrow specificity. The drug is active and has low toxicity. It should play a major role in the fight against the medical, epidemiological and economic effects of influenza A, but it can only be used under a number of conditions: accurate identification of the circulating virus and early administration of the drug (these two prerequisites being somewhat contradictory), selection of the right targets (contacts of recognized cases, subjects constantly exposed to contagion, etc.) and respect of certain contraindication. On the other hand, the theoretical advantages of this type of prophylaxis are important: it may limit contagion (morbidity) or at least reduce the severity of the cases (mortality); it may also prevent an epidemic from penetrating the population treated and thus reduce the severity and costs of the epidemic. The therapeutic use of rimantadine has not yet been officially recommended, but it already seems very promising. Rimantadine should be used as an adjuvant treatment, side by side with immunization against influenza which it cannot replace.