Flu drugs 'unhelpful' in children

Tamiflu is the antiviral being used in the UK

Research has cast doubt on the policy of giving antiviral drugs to children for swine flu.

Work in the British Medical Journal shows Tamiflu and Relenza rarely prevent complications in children with seasonal flu, yet carry side effects.

Although they did not test this in the current swine flu pandemic, the authors say these drugs are unlikely to help children who catch the H1N1 virus.

The government has stuck by its policy of offering them to anyone infected.

The Department of Health said a "safety-first approach" of offering antivirals to everyone remained a sensible and responsible way forward, but promised to keep the policy under review.

There were an estimated 30,000 new cases of swine flu in England in the last week, a drop compared with the 110,000 cases the week before.

A decreased incidence has also been seen in Scotland and Wales in the past week.

The total of swine flu-related deaths in England and Scotland stands at 41.

Antivirals are the mainstay of treatment at the moment until a vaccine becomes available, which is expected in September.

The drugs are designed to ensure that symptoms are mild and reduce the chance of an infected person giving the illness to someone else.

Our research is finding for most children these antiviral drugs are probably not going to have much of an effect Study author Dr Matthew Thompson Q&A: Coping with swine flu

The UK has moved beyond the stage of containing swine flu into the "treatment phase", which means that Tamiflu is only being offered to people who have swine flu and not usually to their contacts.

No effect

While the latest study shows that antivirals can shorten the duration of normal seasonal flu in children by up to a day and a half, it also shows that they have little or no effect on asthma flare-ups, ear infections or the likelihood of children needing antibiotics.

But the drugs can cause unpleasant side effects, such as vomiting with Tamiflu.

Tamiflu has a place but it's not a wonder cure Flu expert Professor Hugh Pennington

There is also the risk that widespread use of the drugs will mean the virus will develop resistance to them.

For most children aged between 1 and 12, the risks associated with taking the drugs may well outweigh any benefits, say the researchers.

They say parents with sick children should make sure they get lots of rest and enough fluids and that they should contact their doctor if the child's condition gets worse.

In most cases, swine flu is a relatively mild disease.

Their work also reveals the effectiveness of using antivirals to contain the spread of flu.

ADVICE FOR PARENTS Most cases of swine flu are relatively mild Children sick with flu should have plenty of rest and fluids Contact the child's doctor if their condition gets worse or there is cause for concern A GP may prescribe Tamiflu, or patients can call the National Flu Service on 0800 1 513 100

They found that 13 people need to be treated to prevent one additional case, meaning antivirals reduce transmission by 8%.

The University of Oxford team, led by Dr Matthew Thompson, carried out a review of four trials on the treatment of seasonal flu in 1,766 children and three trials involving the use of antiviral to limit the spread of seasonal flu in 863 children.

Dr Thompson said: "Our research is finding for most children these antiviral drugs are probably not going to have much of an effect."

Co-researcher Dr Carl Heneghan, a GP and clinical lecturer at Oxford University, said the current policy of giving Tamiflu for mild illness was an "inappropriate strategy".

He said: "The downside of the harms outweigh the one-day reduction in symptomatic benefits."

Flu expert Professor Hugh Pennington said the findings were not surprising and underlined what was already known about Tamiflu.

"Tamiflu has a place but it's not a wonder cure."

A Department of Health spokesman said: "Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals to everyone remains a sensible and responsible way forward.

"However, we will keep this policy under review as we learn more about the virus and its effects.

"The BMJ research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.

"But for those who experience severe symptoms, the best scientific advice tells us that Tamiflu should still be taken as soon as possible - and to suggest otherwise is potentially dangerous. If people are in any doubt about whether to take Tamiflu, they should contact their GP."

Liberal Democrat Shadow Health Secretary Norman Lamb called for an urgent review of the policy.

But Professor Steve Field, chairman of the Royal College of GPs, said the current policy was correct.

Have you given your children Tamiflu or Relenza? Did the antivirals make any difference to their symptoms? Did they suffer from side effects? Or have you decided not to give your children antiviral drugs? Tell us your experiences using the form below.

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