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OSELTAMIVIR FOR INFLUENZA PROPHYLAXIS - new WHO advice

The World Health Organisation has recently updated its list of essential medicines, and says this about Oseltamivir(Tamiflu):

Section 6.4.3: Other antivirals The Expert Committee did not recommend the deletion of oseltamivir from the EML and EMLc, recognizing that it is the only medicine included on the Model Lists for critically ill patients with influenza and for influenza pandemic preparedness. However, the Committee noted that compared to when oseltamivir was first included on the Model List in 2009, there now exists additional evidence of oseltamivir in seasonal and pandemic flu which has reduced the previously estimated magnitude of effect of oseltamivir on relevant clinical outcomes. The Committee recommended the listing of oseltamivir be amended and the medicine be moved from the core to the complementary list, and its use be restricted to severe illness due to confirmed or suspected influenza virus infection in critically ill hospitalized patients. The Expert EML Committee noted that WHO guidelines for pharmacological management of pandemic and seasonal influenza are going to be updated in 2017: unless new information supporting the use in seasonal and pandemic outbreaks is provided, the next Expert Committee might consider oseltamivir for deletion.

This is of course very relevant to GPs in receipt of PHE advise about prescribing; I would hope that national guidelines on this matter will now be altered in advance of this year’s flu season. If not then the WHO advice will be very helpful for GPs which choose to follow it rather than what current PHE guidance says.

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