re: Does tamiflu work as a preventative?

Just took day 4 of Tamiflu, all symptoms gone. Never had flu before, but whole family (in-laws) are saying it was pretty mild based on their experience so they think tamiflu worked well.

Good luck with 1 year old. Strains used for shot missed this year as you know. FWIW my GP said in future get the Quadrivalent flu mist as it has a herding effect for you and family, and the more strains of protection the better

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Ah. In that case, it is probably best thought to fall in the "could help, probably won't hurt" category at this time. I'd probably give/take it if I wasn't paying for it. I also probably wouldn't pay for it.

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Agree. Going to go ahead and take it and give to 4 year old but will immediately stop if I suspect even the smallest negative side effect on her. I have been a basket case all afternoon. I don't handle my kids being sick at all. My heart just breaks for them.

The one and only symptom was that she woke up from a nap this afternoon with a fever. That's it. My kids have not left the house since Friday night to try to avoid getting sick at all possible.

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Did she say why she wouldn't swab? It's pretty common this time of year to occasionally run out of flu swabs due to the volume of potential flu patients they get.

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The flu test isn't all that sensitive (false negatives aren't rare), and she had already made up her mind to treat regardless of what the test was. It's a case of adherence to one of the cardinal rules of practice- never order a test that won't change your management.

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Few studies out there proving that tamiflu does not work. Can any OT docs validate or debunk these findings?

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Link the study/studies you're mentioning if you want a critical analysis of them. I've never seen one that proved Tamiflu didn't work. Most of the studies that showed efficacy showed a reduction in duration of symptoms by ~12 hours with no significant difference in hospital admissions or ICU admissions between the two groups. I forget all the measured surrogate markers of efficacy/outcomes in that specific study.

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Must not have hit AZ as hard as in the South.

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I haven't read the most recent bulletin, so I'm a week out of date, but LA was at the top of the list of flu rate. Something like 85% vs 15% flu A vs B (don't quote me on that one, but I think I'm close and know that it's heavily A-dominant). H3N2 predominant, but the strain in the North American vaccine only accounted for about 35% of the H3N2 (which is the majority of the Flu A infections, by something like 95 to 5 %, H1N1 similar to the 2009 strain being the other) circulating. The other 65% of H3N2 was covered in the Southern Hemisphere flu vaccine but not here in the US.


Given the prevalence of flu in LA (assuming that's where OP is) and it being Christmas time, it's actually pretty reasonable to just go ahead and just save the money on the test to put toward treatment (even if it's all covered by insurance, it's better to keep healthcare costs across the board down), especially when the entire family will be prophylaxed- also a totally reasonable move for the time of year, since now the kid who wasn't sick may get sick, but the parents will feel better because they're already being treated and are thought to be less likely to re-present to the ED. This is really where medicine becomes an art rather than a science. And in this case, it seems to have annoyed the parent rather than keep them calmer/more comfortable, which is unfortunate. But there was likely a lot more thought behind the decision than is being appreciated. I could definitely be wrong, and the NP definitely could have been a moron. But most of the "morons" I have met in my short time in medicine are pretty smart people who simply forget or choose not to take the time to explain why they are treating the patient the way that they do. The majority of the rest are just caught on the wrong end of a no-win situation where they're held responsible. And yes, there are a few genuinely moronic people who I do not understand how they have the job that they do. They've been the minority in my limited experience.

And appears to be dumb as frick herself.

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Those parents typically just want to blame someone else for their frustrations.

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To be quite honest, I find those parents hard to blame. It's much nicer to have someone to blame than to sit down and think "sometimes, life just kind of sucks, and there is nothing that anyone can do about it." And they usually can't put themselves inside the head of the person taking care of them- they just don't have experience with what the job really is or how it really works.

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there's no way it works as a prophylactic therapy...

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It won't prevent people from getting infected by the influenza virus. No one thinks it does. The theory behind prophylactic dosing of it is a very high-risk of infection patient (one with sick household contacts and similar exposure patterns) will very likely have both a reduced severity and longevity of symptoms, possibly even sub-clinical (a la, the patient doesn't get "the flu"), based on the drug's mechanism of action.


I have not seen evidence to support it. It's a very logical theory with very little negative effect other than cost.

Yea that's why it specifically says "symptomatic" influenza. The way neuraminidase inhibitors work, the virus has to have entered and infected the cell already.

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and for the MD's, i know what the frick the package insert claims it does, but knowing exactly how the medication works, there's no way it works as a prophylactic therapy...

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Congrats. Can we start calling you to check on other drugs if we think the package inserts are wrong too?