Look at all the evidence before stockpiling amantadine

doi:10.1136/bmj.39136.489942.FA

BMJ 2007;334:439 (3 March), doi:10.1136/bmj.39136.489942.FA

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Pandemic flu

Look at all the evidence before stockpiling amantadine

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

Tsiodras et al propose testing amantadine to see if any benefitscould accrue in combination with neuraminidase inhibitors inpandemic flu.¹ The principal attraction seems to be low cost.Although they quote resistance and harms as well as lack of"any demonstrable reduction in transmissibility or pathogenicity,"this does not seem to deter them from their proposal.

Had they consulted the Cochrane Library, they would have discoveredthat amantadine (the only adamantane for which we have a reasonableknowledge base) relieves or suppresses symptoms if taken within48 h, but it does not prevent infection with influenza A virusesor stop their nasal excretion. This is the key finding in apandemic as apparently healthy individuals devoid of symptomsand feeling good because they have taken "the pill" would bespreading influenza viruses in the community through contactand droplets. Amantadine suppresses symptoms but not infection,it does not prevent . . . [Full text of this article]

Tom Jefferson, Cochrane Acute Respiratory Infections Group

Anguillara Sabazia, Rome 00061, Italy

jefferson.tom@gmail.com

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