For more than two decades, Tamiflu has been a cornerstone of global pandemic planning.
Governments spent billions stockpiling it, the WHO placed it on its Essential Medicines List, and doctors routinely prescribed it to severely ill flu patients on the assumption that it could prevent complications and save lives.
But until now, no randomised trial had compared Tamiflu with no antiviral in critically ill patients.
The international REMAP-CAP trial has now put that assumption to the test—and found no benefit.
Among 442 critically ill patients with laboratory-confirmed influenza assigned to receive Tamiflu for five days, ten days, or no antiviral, the results were clear.
About 20% of patients given Tamiflu had died by 90 days, compared with about 14% of those who received no antiviral.
In other words, more patients died when they were given the drug.
The authors concluded that Tamiflu was “ineffective and highly likely to increase 90-day mortality” and should no longer routinely be administered to critically ill patients with seasonal influenza.
The new findings are the latest chapter in Tamiflu’s troubled history.