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#Antiviral use and the effects of #drug #resistance on the #transmission dynamics of #influenza

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By G.M.

Abstract

The effectiveness of antivirals in mitigating influenza outbreaks depends on both their ability to reduce the number of infections and the risk of drug resistance. We extended a previously developed mathematical model to investigate the impact of mitigation strategies, including mono or combination antiviral treatment or chemoprophylaxis and vaccination, on influenza transmission dynamics. Our findings indicate that chemoprophylaxis is more effective than treatment in reducing influenza burden, except when the resistant strain has a high transmission rate, in which case chemoprophylaxis may trigger a resistance-driven secondary infection wave. Combination therapy considerably reduces resistance emergence with similar infection numbers as mono-therapy. Vaccination coverage of at least 80% is required to prevent outbreaks; otherwise, antivirals can contribute to outbreak control provided drug resistance emergence is low. This analysis could inform public health decision-making by providing guidance on effective mitigation strategies for influenza outbreaks, considering their benefits against the risk of drug resistance.

Source: MedRxIV, https://www.medrxiv.org/content/10.1101/2025.03.10.25323668v1

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