Flu treatment - zanamivir (review), amantadine and oseltamivir

Summary

NICE considers that having a flu jab (‘immunisation’) is the most effective way of preventing illness from flu, and that the drugs for the treatment of flu shouldn’t be used instead of immunisation.

NICE has recommended that amantadine should not be used for the treatment of flu.

It has also recommended that zanamivir or oseltamivir should not be used to treat a flu-like illness in people who are otherwise healthy (that is, they are unlikely to be at risk of developing complications from flu).

NICE recommends that when the number of people with flu reaches a high-enough level (that is, when influenza virus A or B is said to be ‘circulating in the community’), zanamivir or oseltamivir should be used to treat a flu-like illness in people who are considered to be at risk of developing complications, provided that they can start treatment within 48 hours of the symptoms starting. People who are considered to be ‘at-risk’ are those who are in at least one of the following groups.

• People who:
• are aged 65 years or older
• have long-term (‘chronic’) lung disease (including asthma and chronic obstructive pulmonary disease)
• have heart disease (but not including people who have high blood pressure but do not have other problems with their heart or blood vessels)
• have long-term kidney disease
• have diabetes
• have an immune system that does not work well.

Zanamivir or oseltamivir should be used to treat flu-like illness in at-risk adults (for the purposes of this guidance, this means people aged over 12 years). Oseltamivir should be used to treat flu-like illness in at-risk children (aged over 1 year).

NICE has also recommended that monitoring schemes, such as those organised by the Public Health Laboratory Service and the Royal College of General Practitioners, should be used so that the start of an outbreak of influenza can be spotted as quickly as possible.

This guidance replaces TA15 Flu - zanamivir.

Documents

For healthcare professionals

• TA58 Flu treatment - zanamivir (review), amantadine and oseltamivir: Guidance
• TA58 Flu treatment - zanamivir (review), amantadine and oseltamivir: Summary

For patients, carers and the public

• TA58 Flu treatment - zanamivir (review), amantadine and oseltamivir: Information for the public

Background information

• Review decision - August 2007
• Review proposal - May 2007
• Review proposal - September 2005
• Assessment report: Influenza A and B
• Media Briefing: Guidance on the the use of zanamivir, oseltamivir and amantadine for the treatment of influenza
• 2003/006 NICE issues guidance for diabetes, flu and stress incontinence to improve choice and care for NHS patients in England and Wales

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• None found