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Influenza Treatment Guidelines for Physicians




Influenza Treatment Guide 2009-2010 (adapted from cdc recommendations- 10/1/09)

 

 

 

 

 

Includes BOTH Seasonal Flu and H1N1 Flu

  • Most healthy persons who develop an illness consistent with influenza, or persons who appear to be recovering from influenza, do not need antiviral medications for treatment or prophylaxis. However, persons presenting with suspected influenza and more severe symptoms such as evidence of lower respiratory tract infection or clinical deterioration should receive prompt empiric antiviral therapy, regardless of previous health or age.
  • Treatment with oseltamivir (Tamiflu) or zanamivir (Relenza) is recommended for all persons with suspected or confirmed influenza requiring hospitalization.
  • Early empiric treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who are at higher risk for complications including:
      • Children younger than 2 years old;
      • Persons aged 65 years or older
      • Pregnant women
      • Persons of any age with certain chronic medical or immunosupressive conditions; and,
      • Persons younger than 19 years of age who are receiving long-term aspirin therapy.
      • American Indians/Alaska Natives;
      • persons who are morbidly obese (i.e., body-mass index ≥40);

      • residents of nursing homes and other chronic-care facilities.

      • Clinical judgment, on the basis of the patient’s disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms, is important when making antiviral treatment decisions for high-risk outpatients

    • Children 2 year to 4 years old are more likely to require hospitalization or urgent medical evaluation for influenza compared with older children, although the risk is much lower than for children younger than 2 years old. Children aged 2 to 4 years without high risk conditions and with mild illness do not necessarily require antiviral treatment.
    • Treatment, when indicated, should be initiated as early as possible because studies show that treatment initiated early (i.e., within 48 hours of illness onset) is more likely to provide benefit.

     

  • Dosing
    • See Table 1 (Attached)

 

Table 1.Antiviral medication dosing recommendations for treatment or chemoprophylaxis of 2009 H1N1 infection

Medication

 

Treatment
(5 days)

 

Chemoprophylaxis
(10 days)

 

Oseltamivir

 

Adults

 

 

75-mg capsule twice per day

 

75-mg capsule once per day

 

Children ≥ 12 months

 

Body Weight (kg)

 

Body Weight (lbs)

 

   

≤15 kg

 

≤33lbs

 

30 mg twice daily

 

30 mg once per day

 

> 15 kg to 23 kg

 

>33 lbs to 51 lbs

 

45 mg twice daily

 

45 mg once per day

 

>23 kg to 40 kg

 

>51 lbs to 88 lbs

 

60 mg twice daily

 

60 mg once per day

 

>40 kg

 

>88 lbs

 

75 mg twice daily

 

75 mg once per day

 

Zanamivir

 

Adults

 

 

10 mg (two 5-mg inhalations) twice daily

 

10 mg (two 5-mg inhalations) once daily

 

Children (≥7 years or older for treatment, ≥5 years for chemoprophylaxis)

 

 

10 mg (two 5-mg inhalations) twice daily

 

10 mg (two 5-mg inhalations) once daily

 

 

Additional Information:

Centers for Disease Control: Dosing for children aged less than 12 months

http://www.cdc.gov/h1n1flu/recommendations.htm

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