Despite recent controversies about its effectiveness, clinicians should not forget about using the antiviral, oseltamivir (Tamiflu), to help shorten the course of influenza among patients during the coming flu season. In this exclusive MedPage Today video, Arnold Monto, MD, of the University of Michigan School of Public Health in Ann Arbor, discusses how antivirals may be more important than ever this flu season — both in adult and pediatric populations — with an influenza vaccine that may not be as effective.

Following is a transcript of his remarks:

What’s happening is that we are about to have an influenza outbreak, or it’s already starting. We know that this influenza outbreak in the U.S. is mainly H3N2, which is the one that’s the most severe in terms of causing severe morbidity and mortality.

We also know that the vaccine doesn’t work as well against this kind of influenza, and what we really need to remember is that we should be using Tamiflu as the one licensed antiviral that we have which is commonly available. We have others that are a little harder to get a hold of, but they will shorten the duration of illness and prevent complications. We should not hesitate to use what we’ve got because these drugs are not super drugs.

We know that we need better antivirals, and there are new ones in the pipeline, but they are not currently available. The CDC is very strong in their recommendation in certain risk groups that the antivirals — mainly oseltamivir, Tamiflu — be used in the appropriate situations.

I think the CDC has spoken — as have various other organizations like the Infectious Diseases Society, pediatric groups — [about] appropriate use of antivirals, and we need to remember to use them during the coming flu season because we expect the vaccine to work, but not as well as we would like.

There has been controversy between two journals in terms of how they view Tamiflu, which is very strange because we are all science-based and we should really go on the evidence.

We published an article in Lancet looking at the clinical trials of Tamiflu, and we are now about to publish a paper in Clinical and Infectious Diseases that looks at the effect of Tamiflu in pediatrics. We find that it not only shortens the duration of influenza, but also prevents complications [like] otitis media, which is an important complication that occurs after a case of influenza.