2026-10-14T05:14:32Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33956272 2026-09-21T17:30:57Z category_7 category_8 category_12 category_21 category_272 category_39 category_46 category_734 category_64 category_128 category_132 category_134 portal_5 item_type_3 month_year_09_2026

<p>Assessment of risk for persistence of resistance.</p> Hanna Söderström Lindström (25084549) Sara H. Norström (25084552) Chaojun Tang (2294641) Richard H. Lindberg (272976) Josef D. Järhult (8275536) Medicine Microbiology Cell Biology Biotechnology Environmental Sciences not elsewhere classified Ecology Immunology Biological Sciences not elsewhere classified Cancer Hematology Infectious Diseases Virology mallard model examining assessment combined data justify ia use risk patient groups ias requires balancing aquatic environments inhabited environmental stability ranged lowest environmental risk environmental risk ranking environmental risk posed oc ), zanamivir za ), peramivir aquatic environments environmental stability prudent use environmental release vivo experiments study aimed previously published oseltamivir carboxylate new experiments natural reservoir may contribute highest risks evaluated antivirals dabbling ducks clinical benefits clinical benefit carefully considered avian origin )&# 8212 <div><p>Influenza antivirals (IAs) have been detected in aquatic environments inhabited by dabbling ducks, the natural reservoir of influenza A virus (IAV), raising concerns about the development of antiviral resistance. Because novel human IAV strains often contain genetic material of avian origin, this may contribute to resistance in viruses with pandemic potential. This study aimed to assess the environmental risk posed by four IAs—oseltamivir carboxylate (OC), zanamivir (ZA), peramivir (PE), and amantadine (AM)—based on their potential for environmental release, environmental stability, and induction of antiviral resistance. The assessment combined data from new experiments on (1) environmental release and (2) environmental stability of PE, AM, OC, and ZA, with results from previously published in vivo experiments in a mallard model examining (3) resistance development to OC, PE, and ZA in IAV. The risk of environmental release was assessed as high for OC, AM, and PE, and very high for ZA. Environmental stability ranged from very high to low, in the order PE > AM > OC > ZA. The potential to induce resistance in IAV was similar for PE and OC, and lower for ZA. Overall, the environmental risk ranking was PE > OC > ZA, with PE and OC posing the highest risks. Prudent use of IAs requires balancing the risk of resistance development against clinical benefit. In cases of complicated influenza or in high-risk patient groups, the clinical benefits are substantial and justify IA use. However, in uncomplicated influenza among otherwise healthy individuals, the clinical benefit is limited, and the risk of resistance development should be carefully considered. Among the evaluated antivirals, ZA showed the lowest environmental risk and should be preferred when feasible.</p></div> 2026-09-21T17:30:47Z Dataset Dataset 10.1371/journal.pone.0358447.t006 https://figshare.com/articles/dataset/_p_Assessment_of_risk_for_persistence_of_resistance_p_/33956272 CC BY 4.0