CDC Recommendations For Swine Flu Medications Treatment : H1N1 Influenza

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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CURRENT H1N1 INFLUENZA EPIDEMIC- RECENT UPDATE

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Influenza Virus

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Bhushan Katira
Medical Sciences Department, Pediatric Oncall. Mumbai

Address for Correspondence: Bhushan Katira, 171/11, Basant Vihar Chs, R. B. Mehta Rd., Ghatkopar (E), Mumbai - 400077. Email: drbhushankatira@gmail.com

Continued...

Treatment:

Medications:
CDC has approved the use of antiviral agents like Oseltamivir and Zanamivir whereas drugs like amantadine and rimantadine are to be used since the virus is resistant to them. Antiviral treatment with zanamivir or oseltamivir should be initiated as soon as possible after the onset of symptoms. Evidence for benefits from treatment in studies of seasonal influenza 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 for patients whose treatment was started more than 48 hours after illness onset. Recommended duration of treatment and prophylaxis is shown in Table 1, 2 & 3.

Table 1. Recommended doses of zanamivir and oseltamivir antiviral medications for the treatment of influenza A and B in children 1-18 years-old

	1-6 years	7-18 years
Zanamivir	-	10 mg (2 inhalations) twice daily for 5 days
Zanamivir	Up to 15 kg	15-23kg	23-40 kg	>40kg
Oseltamivir	30 mg twice a day for 5 days	45 mg twice a day for 5 days	60 mg twice a day for 5 days	75 mg twice a day for 5 days

Table 2: Recommended doses of zanamivir and oseltamivir antiviral medications for the prophylaxis of influenza A and B in children 1-18 years-old

	1-4 years	5-18 years
Zanamivir	-	10 mg (2 inhalations) once daily for 10 days after the last known exposure
Zanamivir	Up to 15 kg	15-23kg	23-40 kg	>40kg
Oseltamivir	30 mg once a day for 10 days after the last known exposure	45 mg once a day for 10 days after the last known exposure	60 mg once a day for 10 days after the last known exposure	75 mg once a day for 10 days after the last known exposure

Table 3. Recommended doses of oseltamivir antiviral medication for the treatment and prevention of S-OIV influenza for children less than 1 year of age.

Age	Recommended treatment dose	Recommended prophylaxis dose
<3 months	12 mg twice daily for 5 days	-
3-5 months	20mg twice daily for 5 days	20 mg once a day for 10 days
6-11 months	25 mg twice daily for 5 days	25 mg once a day for 10 days

Antiviral chemoprophylaxis with either oseltamivir or zanamivir is recommended for the following:

Household close contacts who are at high-risk for complications of influenza (children younger than 5 years old, pregnant women, persons =65 years-old and those with certain chronic medical conditions) of a confirmed or suspected case.
School children or daycare attendees who are at high-risk for complications of influenza (children younger than 5 years old, pregnant women, persons =65 years-old and those with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed, probable, or suspected case.
Children who traveled to Mexico who are at high-risk for complications of influenza (children younger than 5 years old pregnant women, persons =65 years-old and those with certain chronic medical conditions).

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