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Whether or not the Tamiflu resistance seen in Egypt over the last few months continues, the danger exists that such resistance could develop again anywhere. In adolescents, up to 18% have been found to develop resistance while taking the drug with seasonal flu, and so reliance on only one class of antiviral is seen as less than desirable
Today, researchers published a paper in the BMJ (British Medical Journal) where they propose the use of an antiviral cocktail consisting of Tamiflu and Amantadine or Rimantadine. Both of the mantadines are older drugs, commonly used for seasonal flu up until a couple of years ago, but discontinued due to high levels of resistance.
This from viewlondon.uk.
Combination of drugs 'needed to fight' flu pandemic
A combination of antiviral drugs is needed to combat a potential influenza pandemic, scientists have warned.
The claim is made in a joint British and Greek study on the importance of stockpiling two classes of drugs that are effective against flu viruses.
Ion channel inhibitors, such as amantadine and rimantadine, are not commonly stored in the event of a flu outbreak despite their effectiveness due to "unacceptable side effects" and their association with a "rapid emergence of resistance".
But the authors of today's study, published in the British Medical Journal (BMJ), strongly contend that the drugs should be used in conjunction with neuraminidase inhibitors, which include oseltamivir and zanamivir.
They write that a combination of the drugs would reduce undesirable side effects and the risk of resistance, as well as playing an "important role in our armoury".
The claims are made following laboratory tests at the University of Athens medical school that showed a mixture of both antivirals could even prevent the emergence of resistant strains of the highly-pathogenic avian influenza H5N1 virus.
"The strongest argument for having ion channel inhibitors available for a pandemic is that we cannot predict the antiviral susceptibility of a novel influenza strain," writes Professor Sotirios Tsiodras.
"Moreover, avian H5N1 strains continue to evolve."
He goes on to say: "Ion channel inhibitors are also considerably cheaper than neuraminidase inhibitors, so the cost implications of maintaining stocks of both types of drug are therefore modest."
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