Abstract

In 1999, Drug and Therapeutics Bulletin (DTB) and the National Institute for Clinical Excellence (NICE) concluded independently that &#9660zanamivir (Relenza) should not be used in managing patients with influenza.1^,2 Recently, after reviewing further evidence, NICE revised its position regarding use of zanamivir in 'at-risk' adults: it now recommends that, under specific circumstances, the drug should be prescribed for patients at risk who are able to start treatment within 48 hours of the onset of influenza-like symptoms.3 We disagree with this revised advice4 for reasons we explain here.