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Correspondence
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Volume 354:1423-1424 March 30, 2006 Number 13
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Oseltamivir Resistance in Influenza A (H5N1) Infection

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by de Jong, M. D.
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To the Editor: De Jong et al. (Dec. 22 issue)1 report resistance to oseltamivir in two of three recent deaths from influenza A (H5N1) virus infection and recommend investigation into new antiviral drugs for use either alone or in combination with oseltamivir. Zanamivir is another licensed neuraminidase inhibitor. Studies with nebulized and intravenous preparations suggest that zanamivir has good safety and efficacy, even in patients with underlying respiratory disease.2,3,4 The H274Y mutation that confers resistance to oseltamivir inpatients with H5N1 infection does not confer cross-resistance to zanamivir, a phenomenon attributable to differences in binding properties.5 A treatment regimen combining these . . . [Full Text of this Article]



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