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To Tamiflu or Not

(Click the link to comment and to vote – voting not working through email, sorry!)

Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

Reviving an old one since it’s pretty relevant again. Added some commentary in the Comments section.

Do you prescribe oseltamivir (brand name Tamiflu) for clinical influenza?

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pemsou5_wp • January 24, 2020

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  1. Kelly March 1, 2021 - 1:28 am Reply

    A useful discussion of the debate regarding oseltamivir use can be found at
    The study cited in this article (Dobson J et al Lancet 2015;385:1729) plus a recent one in Lancet (Butler CC et al Lancet 2019 Dec 12) demonstrate that oseltamivir reduces symptom duration by approximately 1 day. Given the potential side effects, some question the risk benefit ratio. A nice summary of this point of view can be found at and more concisely
    However, literature does support that oseltamivir can reduce mortality in adults with high risk factors, if given early in the course of disease. Data are insufficient for kids, but are often extrapolated from adult data. We are currently in the throes of influenza season, and pediatric deaths is double that of the same time in last season
    CDC recommendations for antiviral use can be found at:
    Summary: hospitalized, severe/complicated illness, high risk for complications (includes children < 2 years old). Most likely to benefit if given in first 48 hours of illness. Personally, I have a hard time ignoring the CDC.
    As those with non-influenza illness do not benefit from oseltamivir, and children have a high rate of other winter viruses, our hospital ID department recommends rapid influenza testing confirmation before initiating oseltamivir for children.

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