Avian influenza medical therapy
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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.
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.
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 amantadine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.
- 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.