When should prophylaxis with antiviral agents be considered in the treatment of H1N1 influenza (swine flu)?

Updated: Apr 09, 2019
  • Author: Michael Stuart Bronze, MD; Chief Editor: Russell W Steele, MD  more...
  • Print
Answer

Prompt initiation of antiviral agents within 48 hours of symptom onset is imperative for providing treatment efficacy against influenza virus. In studies of seasonal influenza, evidence for benefits of treatment is strongest when treatment is started within 48 hours of illness onset. However, some studies of treatment of seasonal influenza have indicated benefit, including reductions in mortality or duration of hospitalization, even in patients in whom treatment was started more than 48 hours after illness onset. The recommended duration of treatment is 5 days. [30, 31]

Prophylaxis with antiviral agents should also be considered in the following individuals (pre-exposure or postexposure):

  • Close household contacts of a confirmed or suspected case who are at high risk for complications (eg, chronic medical conditions, persons >65 y or < 5 y, pregnant women)

  • School children at high risk for complications who have been in close contact with a confirmed or suspected case

  • Travelers to Mexico who are at high risk for complications (eg, chronic medical conditions, persons >65 y or < 5 y, pregnant women)

  • Health care providers or public health workers who were not using appropriate personal protective equipment during close contact with a confirmed or suspected case

  • In September 2009, the CDC updated recommendations concerning the use of antiviral medications for prevention because of reported oseltamivir resistance; antivirals should not be used for postexposure chemoprophylaxis in healthy children or adults to manage outbreaks in the community, school, camp, or other settings. [32]

  • Reserve antiviral chemoprophylaxis for persons at higher risk for influenza-related complications who have had contact with someone likely to have been infected with influenza.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!