Oseltamivir (Tamiflu) and zanamivir (Relenza) are effective for reducing the duration of symptoms of influenza by about 1 day when given to healthy individuals aged <65 years, and if given early in the course of the disease. Benefit to individuals aged >65 years and those with chronic medical conditions were not established.
Important outcomes, such as prevention of death and hospitalization due to influenza, were not discussed. No head-to-head trials were included, and these drugs could be considered interchangeable. Patients in the studies had laboratory confirmation of influenza, something that is not always done in general practice.
Given that these drugs are expensive (about $60 for a typical course), routine use for all flu patients may not be cost-effective. Rather, balancing the cost of treatment against risks and benefits need to be individualized. Use of these drugs should not replace primary prevention strategies.