Avian influenza medical therapy: Difference between revisions

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__NOTOC__
__NOTOC__
{{Avian influenza}}
{{Avian influenza}}'''For more information about seasonal human influenza virus that is not associated with animal exposure, see [[Influenza]]'''<br><br>
Please help WikiDoc by adding content here. It's easy! Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
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==Overview==
[[Neuraminidase]] inhibitors can reduce the duration of [[viral replication]] and improve survival among patients with [[avian influenza]]. In cases of suspected avian influenza, [[oseltamivir]], [[zanamivir]], or [[peramivir]] should be administered as soon possible, preferably within 48 hours of symptom onset.<ref name=":0">Avian Influenza A Virus Infections in Humans. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/avianflu/avian-in-humans.htm Accessed on April 22, 2015
</ref>
 
== Medical Therapy ==
*Preliminary evidence demonstrates that [[neuraminidase inhibitor]]<nowiki/>s can reduce the duration of [[viral replication]] and improve survival among patients with [[avian influenza]]. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset.<ref name=":0" />
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Antiviral Agents for the Treatment of Avian Influenza'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Agent}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Recommended Dose}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Duration}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Oseltamivir]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''75 mg PO once daily'''<br> (Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently)<ref name=":1">Avian Influenza Factsheet. World Health Organization. http://www.who.int/mediacentre/factsheets/avian_influenza/en/ Accessed on April 22, 2015</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |A minimum of 10 days
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Zanamivir]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''10 mg inhaled twice daily''' <br> (Preferred if patients has diarrhea and malabsorption)
| style="padding: 5px 5px; background: #F5F5F5;" |A minimum 5 days
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Peramivir]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''600 mg IV as a single dose''' <br> (Preferred if patients has diarrhea and malabsorption)
| style="padding: 5px 5px; background: #F5F5F5;" |1 day
|-
|}
*The use of [[corticosteroids]] is not recommended.<ref name=":1" />
 
*Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
 
*The use of [[amantadine]] is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.<ref>WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/ Accessed on April 22, 2015
</ref>
* Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.
 
 
::*1. Preferred regimen:[[Oseltamivir]] 75 mg PO qd for a minimum 10 days <ref name=":1">Avian Influenza Factsheet. World Health Organization. http://www.who.int/mediacentre/factsheets/avian_influenza/en/ Accessed on April 22, 2015</ref><ref>{{Cite web| title= avian influenza| url=http://www.cdc.gov/flu/avianflu/avian-in-humans.htm}} </ref>
:::*Note:Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently
::*2. Patients with Avian Influenza who have diarrhea and malabsorption
:::* Preferred regimen (1): [[Zanamivir]] 10 mg inhaled bid for minimum 5 days
:::* Preferred regimen (2): [[Peramivir]] 600 mg IV as a single dose for 1 day
:::* Note(1): Preliminary evidence demonstrates that [[Neuraminidase inhibitor]] can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset.
:::* Note(2): The use of [[Corticosteroids]] is not recommended.
:::* Note(3): Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
:::* Note(4): The use of [[Amantadine]] is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.<ref>WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/ Accessed on April 22, 2015
</ref>
:::* Note(5): Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.


==References==
==References==
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[[Category:Bird diseases]]
[[Category:Bird diseases]]
[[Category:Avian influenza]]
[[Category:Avian influenza]]
[[Category:Infectious disease]]
 
[[Category:Mature chapter]]
[[Category:Animal virology]]
[[Category:Microbiology]]
[[Category:Poultry diseases]]
[[Category:Emergency medicine]]
[[Category:Pulmonology]]
[[Category:Disease]]
[[Category:Infectious Disease Project]]


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{{WH}}
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Latest revision as of 17:04, 18 September 2017

Avian influenza Microchapters

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For more information about seasonal human influenza virus that is not associated with animal exposure, see Influenza

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Neuraminidase inhibitors can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, oseltamivir, zanamivir, or peramivir should be administered as soon possible, preferably within 48 hours of symptom onset.[1]

Medical Therapy

  • Preliminary evidence demonstrates that neuraminidase inhibitors can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset.[1]
Antiviral Agents for the Treatment of Avian Influenza
Agent Recommended Dose Duration
Oseltamivir 75 mg PO once daily
(Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently)[2] 		A minimum of 10 days
Zanamivir 10 mg inhaled twice daily
(Preferred if patients has diarrhea and malabsorption) 		A minimum 5 days
Peramivir 600 mg IV as a single dose
(Preferred if patients has diarrhea and malabsorption) 		1 day
  • Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
  • The use of amantadine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.[3]
  • Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.


  • Note:Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently
  • 2. Patients with Avian Influenza who have diarrhea and malabsorption
  • Preferred regimen (1): Zanamivir 10 mg inhaled bid for minimum 5 days
  • Preferred regimen (2): Peramivir 600 mg IV as a single dose for 1 day
  • Note(1): Preliminary evidence demonstrates that Neuraminidase inhibitor can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset.
  • Note(2): The use of Corticosteroids is not recommended.
  • Note(3): Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
  • Note(4): The use of Amantadine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.[5]
  • Note(5): Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.

References

  1. ↑ 1.0 1.1 Avian Influenza A Virus Infections in Humans. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/avianflu/avian-in-humans.htm Accessed on April 22, 2015
  2. ↑ 2.0 2.1 2.2 Avian Influenza Factsheet. World Health Organization. http://www.who.int/mediacentre/factsheets/avian_influenza/en/ Accessed on April 22, 2015
  3. ↑ WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/ Accessed on April 22, 2015
  4. ↑ "avian influenza".
  5. ↑ WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/ Accessed on April 22, 2015

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