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đ€ą Influenza Virus: Antivirals - #MEDSHED
đ Acute respiratory infection
Negative-strand RNA of Orthomyxoviridae family
Three types of influenza
Influenza A - Humans, swines, equines, birds, Higher susceptibility to antigen variant; pandemics
Influenza B
Influenza C
đ€§ Signs and Symptoms
Cough
Fever
Myalgias
Chills/sweats
Malaise
đ Prevention
CDC and AAFP recommend annual influenza vaccine (> 6 months). Emphasis on high-risk, immunocompromised, and healthcare professionals.
đ Treatment (outpatient)
Primarily supportive care
Antivirals may be considered depending on severity and onset of symptoms
Antiviral agents only reduce severity of symptoms when taken < 48 hours of onset
đ€ Treatment (inpatient)
Hospitalized and those at high-risk of influenza-associated complications
CDC and IDSA recommend antiviral therapy regardless of symptom duration
Antivirals only reduce severity of symptoms
đ Tamiflu (oseltamivir) - enteral
Neuraminidase inhibitor, decreases release of viral particles
Treatment: 75 mg po BID x 5 days, may consider longer in high risk
Px: 75 mg po daily (areas of outbreak)
Renally metabolized
Rapivab (peramivir) - IV
Neuraminidase inhibitor, decreases release of viral particles
Treatment (hospitalized): 600 mg IV daily x 5 - 10 days
Reserved for patients unable to tolerate enteral oseltamivir
Renally metabolized
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References
Gaitonde DY, Moore FC, & Morgan MK. Am Fam Physician. 2019 Dec 15;100(12):751-758.
Uyeki TM, Bernstein HH, Bradley JS, et al. Clin Infect Dis. 2019 Mar 5;68(6):e1-e47.
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