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 Clinical Excellence (NICE) on the use of neuraminidase inhibitors recommend oseltamivir for the treatment of at risk children with influenza-like illness of fewer than 48 hours' duration—for example, those with underlying chronic respiratory disease.¹ The drug is not recommended for otherwise healthy children.

In our systematic review on the use of neuraminidase inhibitors in children, however, we found no published studies on the effectiveness of oseltamivir in reducing the duration of illness in at risk, rather than healthy, children.² Despite this, unpublished data from at risk children seem to exist and were made available by the manufacturers of oseltamivir during their application for European Marketing Authorisation for the drug. In the ensuing European Public Assessment Report, reference is made to results from 178 children with chronic asthma and confirmed influenza infection enrolled in study WV15759/WV15871.³ The stated difference in time to freedom . . . [Full text of this article]

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

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

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

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