February 1, 2008

CDC Survey Shows Less Effective Flu Medications Still Used

FluA recent survey conducted by the Centers for Disease Control and Prevention (CDC) suggests that many primary care physicians (PCPs) prescribed amantadine and rimantadine last influenza season despite a warning about viral resistance. PCPs are also using the rapid antigen test more than any other influenza testing method, which CDC cautioned has low sensitivity.

The survey was sent out to several academic institutions and state health departments in CDC’s Emerging Infections Program. The PCPs were asked which influenza medications they prescribed and which test they used, if any, when evaluating patients with influenza-like illness.

According to CDC, about 25 percent of the PCPs surveyed still prescribed the influenza medicines amantadine and rimantadine. CDC warned in January 2006 that widespread resistance to these drugs had emerged among influenza A strains.

Oseltamivir (Tamiflu) was the most prescribed medication for influenza (87 percent). Zanamivir (Relenza) was the least prescribed medication (5.3 percent).

When the PCPs saw the need for an influenza test, the most frequently used method was the rapid antigen test., The second-most common method was viral culture, followed by a serologic test. Due to low sensitivity of the rapid antigen test, which can miss up to 30 percent of cases, CDC urges physicians to use clinical judgment when testing for influenza.

The survey was published in the January 25, 2008 Morbidity and Mortality Weekly Report (57(03);61-65).

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