What is the role of medications in the treatment of avian influenza?

Updated: Feb 12, 2020
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Current WHO and CDC guidelines recommend treatment regimens with a neuraminidase inhibitor, preferably oseltamivir. Studies are ongoing as to the relative effectiveness of high-dose and/or prolonged courses of therapy with oseltamivir. [14] If high-dose regimens prove to be more effective, the availability of antiviral medication in the event of a massive outbreak, as well as treatment considerations for mildly versus severely ill people, would be affected.

Zanamivir has not yet been tested in people with H5N1 disease, but animal studies are promising and the resistance mutations to oseltamivir do not cause cross-resistance. Some researchers have recommended dual therapy with both existing neuraminidase inhibitors. One concern is that inhaled zanamivir is unlikely to reach distal airways in severe disease. [14]

Currently, the CDC is recommending against using the M2 ion-channel blockers amantadine and rimantadine for routine influenza treatment or prophylaxis because of increasing resistance rates. [18]

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