February 11, 2016

We all expected influenza to hit and finally it is here.  It coincides with the peak of February and March 2015.  Most of the strains this year are supposedly covered by the flu vaccine however, many of the people we have seen with the flu report receiving this year’s vaccine.

Certainly, no vaccine is 100% effective so it is probably best to mask up again this year.

 

Summary of CDC Influenza Antiviral Treatment Recommendations

  • Clinical trials and observational data show that early antiviral treatment can shorten the duration of fever and illness symptoms, and may reduce the risk of complications from influenza (e.g., otitis media in young children, pneumonia, and respiratory failure).
  • Early treatment of hospitalized patients can reduce death.
  • In hospitalized children, early antiviral treatment has been shown to shorten the duration of hospitalization.
  • Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset.
  • Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who:
    • is hospitalized;
    • has severe, complicated, or progressive illness; or
    • is at higher risk for influenza complications.

Table 2. Persons at higher risk for influenza complications who are recommended for antiviral treatment

Persons at higher risk for influenza complications recommended for antiviral treatment include:
  • children aged younger than 2 years;1
  • adults aged 65 years and older;
  • persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus), or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle, such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury);
  • persons with immunosuppression, including that caused by medications or by HIV infection;
  • women who are pregnant or postpartum (within 2 weeks after delivery);
  • persons aged younger than 19 years who are receiving long-term aspirin therapy;
  • American Indians/Alaska Natives;
  • persons who are morbidly obese (i.e., body mass index is equal to or greater than 40); and
  • residents of nursing homes and other chronic care facilities.

 Recommended Dosage and Duration of Influenza Antiviral Medications for Treatment or Chemoprophylaxis

Antiviral Agent Use Children Adults
Oseltamivir (Tamiflu®) Treatment
(5 days)		 If younger than 1 yr old1:
3 mg/kg/dose twice daily2,3
If 1 yr or older, dose varies by child’s weight:
15 kg or less, the dose is 30 mg twice a day
>15 to 23 kg, the dose is 45 mg twice a day
>23 to 40 kg, the dose is 60 mg twice a day
>40 kg, the dose is 75 mg twice a day		 75 mg twice daily
Chemo-prophylaxis
(7 days)		 If child is younger than 3 months old, use of oseltamivir for chemoprophylaxis is not recommended unless situation is judged critical due to limited data in this age group.
If child is 3 months or older and younger than 1 yr old1
3 mg/kg/dose once daily2
If 1 yr or older, dose varies by child’s weight:
15 kg or less, the dose is 30 mg once a day
>15 to 23 kg, the dose is 45 mg once a day
>23 to 40 kg, the dose is 60 mg once a day
>40 kg, the dose is 75 mg once a day		 75 mg once daily
Zanamivir4 (Relenza®) Treatment
(5 days)		 10 mg (two 5-mg inhalations) twice daily
(FDA approved and recommended for use in children 7 yrs or older)		 10 mg (two 5-mg inhalations) twice daily
Chemo-prophylaxis
(7 days)		 10 mg (two 5-mg inhalations) once daily
(FDA approved for and recommended for use in children 5 yrs or older)		 10 mg (two 5-mg inhalations) once daily
Peramivir4 (Rapivab®) Treatment
(1 day)		 N/A
(FDA approved and recommended for use in adults 18 yrs and older)		 One 600 mg dose, via intravenous infusion for 15-30 minutes
Chemo-prophylaxis N/A N/A

 

 

Source: 1c1be0c5-a0ef-4192-b36f-2385295407bc.pdf