Antiviral drugs are important in the management of seasonal influenza and critical to pandemic planning. Although several other classes of anti-influenza compounds exist, the neuraminidase (NA) inhibitors are currently the only option in most clinical settings. These drugs, zanamivir and oseltamivir, prevent the release of newly replicated influenza virions from infected cells. They are highly effective when used for treatment of seasonal influenza early in the course of infection, or for prevention when given soon after exposure. Treatment strategies for avian influenza infections in humans are still provisional owing to inadequate clinical data. As predicted by molecular studies, resistance to the NA inhibitors is now emerging, although at a level less significant than adamantane resistance. NA inhibitor resistance is a cause for concern if indeed some mutant strains of avian influenza are transmissible and pathogenic. In the near term, appropriate use of the available NA inhibitors will be of major benefit in lessening morbidity and mortality due to influenza infection. Priorities include developing appropriate formulations and guidelines for use of these drugs in children and people infected with avian influenza, study of the mechanisms and clinical significance of drug resistance, and identification of new antiviral therapies that target different points in the viral life cycle in order to limit the effect of emerging drug resistance.

中文翻译：

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流感感染的医疗管理。

抗病毒药物在季节性流感的管理中很重要，对大流行的规划至关重要。尽管存在其他几种抗流感化合物，但神经氨酸酶（NA）抑制剂目前是大多数临床环境中的唯一选择。扎那米韦和奥司他韦这些药物可防止受感染细胞释放出新复制的流感病毒粒子。当在感染过程中早期用于治疗季节性流感，或在接触后立即给予预防时，它们非常有效。由于临床数据不足，人类禽流感感染的治疗策略仍是临时的。正如分子研究所预测的那样，尽管其水平不如金刚烷抗性重要，但目前正在出现对NA抑制剂的抗性。如果确实有些禽流感突变株是可传播的且具有致病性，则NA抑制剂耐药性值得关注。在短期内，适当使用可用的NA抑制剂将在降低由于流感感染引起的发病率和死亡率方面具有重大益处。优先重点包括为在儿童和禽流感感染者中使用这些药物制定适当的制剂和指南，研究耐药性的机制和临床意义，以及确定针对病毒生命周期不同点的新抗病毒疗法，以便限制了新出现的耐药性的影响。适当使用可用的NA抑制剂将在减少因流感感染引起的发病率和死亡率方面大有裨益。优先重点包括为在儿童和禽流感感染者中使用这些药物制定适当的制剂和指南，研究耐药性的机制和临床意义，以及确定针对病毒生命周期不同点的新抗病毒疗法，以便限制了新出现的耐药性的影响。适当使用可用的NA抑制剂将在减少因流感感染引起的发病率和死亡率方面大有裨益。优先重点包括为在儿童和禽流感感染者中使用这些药物制定适当的制剂和指南，研究耐药性的机制和临床意义，以及确定针对病毒生命周期不同点的新抗病毒疗法，以便限制了新出现的耐药性的影响。