Minimal benefits from neuraminidase inhibitors in influenza

The neuraminidase inhibitors (NIs) oseltamivir and zanamivir both reduced the time to symptomatic improvement in adults (but not asthmatic children) with influenza-like illness. The size of this effect was small, approximately half a day. Neither agent reduced the risk of complications of influenza, particularly pneumonia, nor reduced the risk of hospitalisation or death, even in groups at higher risk of complications, such as children with asthma and the elderly. When used to prevent the occurrence of influenza in individuals or families, there was minimal effect. Oseltamivir increased the risk of adverse effects, such as nausea, vomiting, psychiatric effects and renal events in adults, and vomiting in children. Overall, there was little support for the use of NIs to prevent serious outcomes, or as prophylactic agents during influenza epidemics.