Do antivirals work on children?

Yesterday in the media there were several reports about antivirals being less effective for children. This was in response to a new BMJ paper that was a meta analysis on other studies.

However, there's probably less new information here than might appear from media reports. We already knew that antivirals were not necessarily a panacea for flu. The study basically reinforces that - antivirals work, but they're not always that great.

Effect Measure, a highly respected public health blog, wrote on the subject today:

"Antivirals aren't like antibiotics, where you can sometimes work almost miraculous cures. If they work, they work at the margins. With those prejudices of mine as background, I can state that one clear message of the 2005 review and this one is that both of these drugs work to some extent. You wouldn't get that idea at all if all you read was the news headlines (the BBC again: Flu drugs 'unhelpful' in children). They not only work, but they work on every single measure examined: reduction of time with symptoms (.5 days to 1.5 days); time of illness (.4 days to 1.5 days), where this was defined as resolution of all symptoms and resolution of fever and return to school or normal activities; reduction in cough or fever (1.3 days for Tamiflu, "reduced incidence of moderate or severe cough" at day five with Relenza); reduction in asthma exacerbation; improvement in pulmonary function; reduction in antibiotic use; reduction in otitis media (middle ear infection) at day 10; and in confirmed secondary cases with an infected index case (reduction in transmission of about 8%)."

I highly recommend the whole blog here:

http://scienceblogs.com/effectmeasure/2009/08/flu_antivirals_the_good_news_t.php