What are the guidelines for antiviral therapy in the treatment of influenza A and B?

Updated: Jan 29, 2019
  • Author: Christian E Sandrock, MD, MPH, FCCP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

When used as treatment, initiation of antiviral agents should not be delayed and ideally should be started within 48 hours of the onset of symptoms. The regimens are based on patient age and weight. [3, 4, 5, 6, 7, 2]

Infectious Disease Society of America guidelines for antiviral therapy for influenza

The Infectious Disease Society of America (IDSA) guidelines for influenza antiviral therapy are as follows: [2]

High-risk individuals

Clinicians should initiate antivirals as soon as possible for adults and children with documented or suspected influenza, irrespective of influenza vaccination history, in the following cases:

  • Hospitalized with influenza, regardless of illness duration before hospitalization
  • Outpatients with severe or progressive illness, regardless of illness duration
  • Children younger than 2 years and adults aged 65 years or older
  • Women who are pregnant or within 2 weeks postpartum

Individuals not at high risk

Clinicians may consider antivirals for individuals with documented or suspected influenza, irrespective of influenza vaccination history, in the following cases:

  • Outpatients with illness onset 2 days or less
  • Symptomatic outpatients with household contacts at high risk
  • Symptomatic healthcare providers who care for patients at high risk, particularly those who are severely immunocompromised

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