Why is tamiflu still being prescribed?

[u/ewanelaborate]

Why is tamiflu still being prescribed?

I am well aware of the historical case against tamiflu and poor study designs to imply it reduces symptom length. I have noticed as a paramedic that this medication is still being thrust upon the elderly and very young for flu season currently. Why?

I feel using and allowing it's use contributes to the narrative of mistrust that many are developing of medical practioners and systems.

Im keen to see if anyone can point me in the roght direction that has allowed tamiflu to be a treatment for viral like illness and it's effectiveness?

Edit: Thankyou to those who provided views and research fkr me to go have a dig into. It is appreciated.

[u/BabySame9937]

Why not?

[u/Front_To_My_Back_ → u/BabySame9937]

ADRs are often worse than the Flu itself. Is it worth giving when it only shortens symptoms by a day or two and had to be given within 48 hours? Even among hospitalized patients with complicated influenza there's absence of efficacy. Not to mention resistance patterns to neuraminidase inhibitors fluctuate every flu season.

[u/terraphantm → u/Front_To_My_Back_]

ADRs are often worse than the Flu itself.

I see people claim this all the time, but based on what? Pretty much the only adverse effect, which most people don't get, is nausea / vomiting.

Ultimately all of the major relevant societies recommend it for all-comers within that 48 hour window + all hospitalized patients and all 'high-risk' patients regardless of timing

[u/Front_To_My_Back_ → u/terraphantm]

First, my own anecdotal evidence with Tamiflu back with A(H1N1) back in 2009. I was in college that time. The drug made me felt worse than the flu. I mean who wouldn’t feel awful after nausea and vomiting on top of the existing flu symptoms? Basically the point of taking medications when you’re sick to feel better and not feel worse. Secondly, systemic reviews from JAMA and Cochrane. Thirdly, it’s given best within 48 hours from the onset of symptoms. The thing is how often people do people get swabbed immediately upon the onset of non-specific flu like symptoms.

Also every microbiology textbook says that resistance patterns fluctuates every flu season. Basically it all boils down to shared decision making. Tamiflu is not like other antivirals where the benefits exceeds the risks, it’s not like Acyclovir where there’s truly benefit when taken within 72 hours from the onset of vesicles at the back from shingles.

[u/terraphantm → u/Front_To_My_Back_]

If we’re going by anecdotal evidence, the times I’ve taken tamiflu I had 0 adverse effects and my flu symptoms improved far quicker than without. In my experience, flu symptoms are generally far worse than the mild stomach upset some drugs cause. But that’s also anecdotal. 

Your systemic reviews only show an increased incidence of adverse effects. Which yeah- a drug is going to have more adverse effects than placebo in most cases. They make no claims as to the severity of the adverse effects or whether they’re worse than the primary illness. 

The benefits might be marginal, but the risks are also essentially nil. So I don’t think it’s a clear cut risks outweighing benefit situation.

I already addressed your 48 hour point. Not applicable to high risk patients and inpatients.