The years 2009–2010 saw the ﬁrst pandemic virus in several decades. Only in retrospect has the low pathogenicity of the virus been able to be conﬁrmed. The pandemic saw as many deaths per capita as a seasonal inﬂuenza virus, but with the signiﬁcant difference that the young (<18 years) were atypically impacted over those > 18 years old (Kamigaki and Oshitani, 2009). Pharmaceuticals played an important part of health care during the inﬂuenza pandemic. Many nations implemented huge stockpiles of antivirals in response to the pandemic, but owing to the low pathogenicity of the virus, there was a negligible increase in existing antibiotic use over interpandemic usage. However, current estimates for antiviral and antibiotic use during a moderate and severe inﬂuenza pandemic are without historical precedent (Singer et al., 2011). Here we discuss the environmental and human health implications of a moderate or severe inﬂuenza pandemic with regard to Tamiﬂu itself and the use of antibiotics to treat secondary bacterial infections. Antibiotic use will be framed in the context of existing paradigms of antibiotic treatment and how these practices already contribute to human and environmental hazards and how these hazards might be minimized in the event of a moderate or severe inﬂuenza pandemic
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