Avian influenza medical therapy: Difference between revisions

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*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.
*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.


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''''Antiviral Agents for the Treatment of Avian Influenza'''''
|+'''''Antiviral Agents for the Treatment of Avian Influenza'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Agent}}
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Agent}}
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| style="padding: 5px 5px; background: #DCDCDC;" |'''Oseltamivir'''
| 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 malabsorption)
| 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)
| style="padding: 5px 5px; background: #F5F5F5;" |A minimum of 10 days
| style="padding: 5px 5px; background: #F5F5F5;" |A minimum of 10 days
|-
|-
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*The use of corticosteroids is not recommended.
*The use of corticosteroids is not recommended.


*In cases of severe infection with the A(H5N1) or A(H7N9) virus, clinicians may need to consider increasing the recommended daily dose or/and the duration of treatment.
*Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.


*In severely ill A(H5N1) or A(H7N9) patients or in patients with severe gastrointestinal symptoms, drug absorption may be impaired. Most A(H5N1) and A(H7N9) viruses are predicated to be resistant to adamantine antiviral drugs, which are therefore not recommended for use.
*The use of adamantine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.


==References==
==References==

Revision as of 15:12, 23 April 2015

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

Overview

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamivir and zanamivir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

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.
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)
A minimum of 10 days
Zanamivir 10 mg inhaled twice daily for 5 days
(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
  • The use of corticosteroids is not recommended.
  • Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
  • The use of adamantine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.

References

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