Tamiflu must be used carefully; steroids are safe
We represent two professional bodies of respiratory physicians and we appreciate the determination and efforts of the Hong Kong government in controlling the recent influenza epidemic.
The public should be praised for its willingness to remain vigilant and its adherence to various recommendations from health care professionals. As respiratory physicians, we owe our community a duty of care to provide the right information. We would like to clarify two recent issues regarding influenza.
First, Tamiflu (Oseltamivir), an anti-viral drug against flu A and B, should not be made an over-the-counter drug.
It is useful as treatment, pre- and post-exposure prophylaxis for influenza A and B. However, there is evidence to show that liberal use of the drug could lead to the emergence of resistant strains. According to the most recent report from the World Health Organisation in March, the resistance rate of influenza A (H1N1) to Tamiflu in Hong Kong is 11 per cent, the highest rate in the western Pacific region.
The WHO had reported resistance to Tamiflu in flu viruses before, but at a much lower rate - typically, 0.5 per cent. Thus, we want to send a clear message to the community - Tamiflu should only be prescribed judiciously by adequately trained health care professionals to avoid the emergence of resistance, rendering it ineffective in life-threatening situations.
Though its efficacy in avian influenza (H5N1) awaits further study, Tamiflu forms part of the WHO-recommended treatment for this condition. Its efficacy against influenza must be preserved by appropriate usage.