The continuing drive to vaccinate at-risk patients and key health workers against flu is an evidence-based objective, proven to save lives and reduce sickness in healthcare establishments. HSJ has emphasised the importance of such campaigns as good practice and as part of the 'winter planning process' (Shot down, pages 26-29, 2 November).

The National Institute for Clinical Excellence's decision to allowed limited prescription of zanamivir (news, page 7, 23 November), termed the 'only proven treatment' for flu, has prompted us to write of our experience last winter.

Zanamivir is not the only proven treatment.

Evidence suggests both amantadine and rimantadine are effective treatments for influenza A. The former has been available for some time, having obtained its licence in 1966.

Amantadine was mentioned in the last NICE review of zanamivir, and it is also mentioned in the 'green' guide to vaccination.

During last winter, given the added pressure of millennium planning and a low uptake of flu vaccine by key staff (around 3 per cent), we chose to make amantadine available to individuals presenting with classical symptoms of flu. We treated 74 staff, with an 82 per cent success rate. Success was defined as two days or fewer off work. The majority of successes did not have any time off and were impressed with the treatment. We estimate that the trust 'gained' 95158 working days that would otherwise have been lost. We have no doubt that by making this drug available (cost around£1.36) we were able to maintain services in what were very busy times.

We will make the preparation available again this year, and would recommend that other trusts consider adding this extra opportunity to assist their winter planning actions. We find it strange that all the articles written on this subject and the present press interest fail to mention that such a simple measure is available, especially given that we appeared on Health Watchdog last Christmas.

Any interested individuals are welcome to contact Ken Ball on 01946 - 693181 bleep 3766.

Ken Ball Director of pharmacy and pathology Brian Earley Acting chief executive West Cumbria Heath Care trust