Abstract

Current data about the role of adamantanes and neuraminidase inhibitors (NIs) in the chemoprophylaxis against influenza viruses were reviewed. We found significant evidence favouring the role of NIs in the chemoprophylaxis of influenza. Awareness and prudent use are necessary, due to recent evidence of gradually increasing resistance of several influenza strains to these agents. On the other hand, the role of adamantanes appears to have decreased over the last decade. Both pre-pandemic and the novel pandemic A/H1N1 2009 strains exhibited either increasing rates of resistance or no susceptibility to adamantanes. Adamantanes currently only have a theoretical role in influenza chemoprophylaxis given the likelihood of the occurrence of an epidemic due to a susceptible strain. In conclusion, changes in antiviral susceptibility will affect future guidance in prophylaxis against influenza. Further investigation of novel medications with new mechanisms of action is important in this regard. Meanwhile, implementing strategies to conserve our current antivirals is necessary.

Keywords: Influenza, antivirals, chemoprophylaxis, adamantanes, neuraminidase inhibitors