Avian influenza medical therapy
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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.
| 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.