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To the Editor: With current concerns about a global influenza pandemic, the study by Dr Bright and colleagues¹ and the accompanying editorial by Drs Weinstock and Zuccotti² discussing accelerating adamantane resistance in community-acquired influenza A are alarming. The US Centers for Disease Control and Prevention (CDC) has done an effective job of disseminating this information and instructing clinicians to substitute neuraminidase inhibitors (NIs) as treatment and chemoprophylaxis for influenza this year.³ However, if overuse of adamantane derivatives has resulted in an increase of resistance in US isolates from 1.9% in 2004 to 92.3% in December 2005, I suggest that we should make every attempt to preserve the efficacy of NIs by using them judiciously and with restraint.

While the CDC recommends priority use of influenza antiviral medications for "any person experiencing a potentially life-threatening influenza-related illness" and for "any person at high risk for serious complications of influenza and who . . . [Full Text of this Article]

Katherine M. Shea, MD, MPH
tkmjshea@mindspring.com
North Carolina State University
Raleigh

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