The importance ov virus drug-resistance in the treatment of influenza with rimantadine

Specific Antiviral Therapy of Respiratory Viruses

“…A sensible approach is to recommend that the presence or absence of drug-resistant viruses should continue to be monitored in clinical trials but to acknowledge that at present the problem at the clinical level is minimal and does not require changes in already published recommendations from the WHO consensus meeting [8] on the clinical use of amantadine or rimantadine. Essentially similar conclusions have been presented already in the UK [45], the USA [9,43] and in the former USSR [38].…”

“…• These recommendations are an amalgam of those first published following the NIAID meeting (1980) and the Vienna WHO meeting [8] t Amantadine or rimantadine cannot be used as a replacement for influenza vaccine in the elderly or those at special risk [14] because the drugs do not inhibit influenza B virus administration of rimantadine (compared with amantadine) and thus dosage is reduced two-fold to 100 mg daily. The rimantadine compound was first discovered in the USA at the du Pont laboratories, but its apparent advantages in the clinic were first noted in the former USSR, where the drug has since been used extensively [38]. In the last few years scientific interest in rimantadine has been revived in the USA and the compound is now licensed there for clinical use.…”

Amantadine for influenza A.

“…Illnesses caused by resistant strains are probably no more severe than those caused by wild strains of the virus, and although the emergence of drug resistance is of concern, no reduction of drug efficacy was observed in the Soviet Union over a 20 year period when 142 227 patients were treated with rimantadine. 9 Currently only amantadine is licensed for use in the United Kingdom. The drug is almost completely absorbed when taken orally and is excreted unchanged in the urine.…”

“…The recommended prophylactic and therapeutic dose of amantadine is 200 mg daily, reduced to 100 mg in those aged [10][11][12][13][14][15] or over 65; the suggested dose in children aged [1][2][3][4][5][6][7][8][9] years is 2 to 4 mg/kg. The possibility that drug resistance will increase with the extensive use of amantadine, its minor adverse effects on the central nervous system, and the logistic difficulties in organising timely prophylaxis and treatment underscore the importance of immunisation.…”

Prevention of Community-Acquired Pneumonia

“…homes during influenza epidemics. Still, the longterm implications of the emergent resistant strains with treatment are uncertain, as no reduction in efficacy of rimantadine was observed after 20 years of follow-up in over 142,000 patients in the former Soviet Union 82.…”