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 Re: WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza (Re: ombadda)
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Study Highlights
When antiviral medications for influenza are available, patients with confirmed or strongly suspected infection with influenza pandemic (H1N1) 2009 should be treated as follows:
All patient groups, including pregnant women, neonates, and young children younger than 5 years, with severe or progressive clinical illness should be treated as soon as possible with oseltamivir (strong recommendation, low-quality evidence).
Higher doses up to 150 mg twice daily and longer duration of treatment may be needed, depending on clinical response.
Patients with severe or progressive clinical illness should receive zanamivir when oseltamivir is not available or not possible to use, or when the virus is resistant to oseltamivir but known or likely to be susceptible to zanamivir (strong recommendation, very low-quality evidence).
Patients considered to be "at risk" are infants and children younger than 5 years, adults older than 65 years, nursing home residents, pregnant women, patients with chronic comorbidities (cardiovascular, respiratory or liver disease, and diabetes), and immunosuppressed patients as a result of malignant disease, HIV infection, or other diseases.
Patients not in "at-risk" groups with uncomplicated illness because of confirmed or strongly suspected H1N1 infection may not need antiviral treatment (weak recommendation, low-quality evidence).
Patients in "at-risk" groups with uncomplicated illness because of confirmed or strongly suspected H1N1 infection should be started with oseltamivir or zanamivir treatment as soon as possible after illness onset (strong recommendation, very low-quality evidence).
Specific recommendations regarding use of antivirals for chemoprophylaxis of pandemic (H1N1) 2009 influenza virus infection are as follows:
Oseltamivir or zanamivir may be used postexposure as chemoprophylaxis when risk for human-to-human transmission of influenza is high or low, and risk for complications of infection is high, either because of the influenza strain or because of the baseline risk for the exposed group:
In this setting, oseltamivir or zanamivir may be used in the affected community or group, in individuals in "at-risk" groups, or in healthcare workers (weak recommendation, moderate-quality evidence).
If the risk for complications of infection is low, individuals in "at-risk" groups or healthcare personnel may not need antiviral chemoprophylaxis, independent of risk for human-to-human transmission (weak recommendation, low-quality evidence).
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ombadda
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