Guidelines on neuraminidase inhibitors in children are not supported by evidence

doi:10.1136/bmj.328.7433.227

BMJ 2004;328:227 (24 January), doi:10.1136/bmj.328.7433.227

Letter

Guidelines on neuraminidase inhibitors in children are not supported by evidence

The first 150 words of the full text of this article appear below.

EDITOR—Guidelines from the National Institute for ClinicalExcellence (NICE) on the use of neuraminidase inhibitors recommendoseltamivir for the treatment of at risk children with influenza-likeillness of fewer than 48 hours' duration—for example,those with underlying chronic respiratory disease.¹ The drugis not recommended for otherwise healthy children.

In our systematic review on the use of neuraminidase inhibitorsin children, however, we found no published studies on the effectivenessof oseltamivir in reducing the duration of illness in at risk,rather than healthy, children.² Despite this, unpublished datafrom at risk children seem to exist and were made availableby the manufacturers of oseltamivir during their applicationfor European Marketing Authorisation for the drug. In the ensuingEuropean Public Assessment Report, reference is made to resultsfrom 178 children with chronic asthma and confirmed influenzainfection enrolled in study WV15759/WV15871.³ The stated differencein time to freedom . . . [Full text of this article]

Mkael Symmonds, preregistration house officer

Department of Surgery, Ayr Hospital, Ayr KA6 6DX mkael@doctors.org.uk

Nicholas J Matheson, preregistration house officer

Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU

Anthony Harnden, university lecturer

Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF

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