Contributed equally to this work.
Stream 4: Review Summary
Antivirals for influenza: a summary of a systematic review and meta-analysis of observational studies
Article first published online: 27 AUG 2013
© 2013 Blackwell Publishing Ltd
Influenza and Other Respiratory Viruses
Special Issue: Proceedings from the WHO Meeting on Global Research for Influenza. Guest Editor: Nahoko Shindo. Publication of this supplement was supported by the Government of Japan
Volume 7, Issue Supplement s2, pages 76–81, September 2013
How to Cite
Antivirals for treatment of influenza: a systematic review and meta-analysis of observational studies. Annals of Internal Medicine 2013; 7(Suppl. 2), 76–81.et al.
- Issue published online: 27 AUG 2013
- Article first published online: 27 AUG 2013
- World Health Organization and McMaster University
- M2 ion channel blocker;
- neuraminidase inhibitor;
- observational study
Despite the use of antivirals to treat patients with severe influenza, questions remain with respect to effects and safety. Although a recent systematic review has provided some indication of benefit, the analysis is limited by the quality of the available evidence from randomized controlled trials. To supplement the existing information, the authors conducted a systematic review of observational studies of antiviral treatment for influenza. This report summarises the findings of that review. Similar to the randomised trials, the confidence in the estimates of the effects for decision-making is low to very low primarily due to the risk of selection and publication bias in the observational studies. From these observational studies, the summary estimates suggest that oseltamivir may reduce mortality, hospitalisation and duration of symptoms compared with no treatment. Inhaled zanamivir may also reduce symptom duration and hospitalisations, but patients may experience more complications compared with no treatment. Earlier treatment with antivirals is generally associated with better outcomes than later treatment. Further high-quality evidence is needed to inform treatment guidelines because of the overall low to very low quality of evidence.