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Half of Tamiflu prescriptions went unused during 2009 H1N1 swine flu pandemic, UK sewage study
Date:4/17/2013

y diverting limited antiviral stocks from those who may need it most. Mis-used antivirals can lead to antiviral resistance and represents a significant financial cost and health risk. Previous research on antiviral compliance had focused on small populations, typically fewer than 200, and used survey-based analyses of drug compliance, which can be unreliable.

Dr Singer adds, "Our study was the first compliance study to utilise waste water as an evidence base for whether a population consumed Tamiflu or not. Because of this unique study design, we were able to examine populations orders of magnitude larger than previous studies. One population was just over 6,000 people and the second population was 208,000. Tamiflu gets transformed into the active antiviral only after being consumed, and is released into the sewage with every visit to the toilet. This waste water epidemiology approach is particularly robust for drugs such as Tamiflu and potentially more reliable than some survey based methods of assessing compliance."

Predictions of oseltamivir consumption from Tamiflu recovered in sewage were compared with two sources of national government statistics to derive compliance rates. Scenario and sensitivity analysis indicated an estimated compliance rate between 45-60%, (between 45 to 60 people out of every 100 people who received Tamiflu completed the antiviral course, as prescribed).

Dr Singer says, "With approximately half the collected antivirals going unused, there is a clear need to improve public health messages so that less antiviral is wasted and that the duration and severity of infection is reduced. Furthermore, we feel the waste water epidemiology approach undertaken can potentially help shape future public health messages, making them more timely, targeted, and population sensitive, while potentially leading to less mis- and un-used antiviral, less wastage and ultimately a more robust and efficacious pandemic preparedness st
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Contact: Barnaby Smith
bpgs@ceh.ac.uk
44-079-202-95384
Centre for Ecology & Hydrology
Source:Eurekalert

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