Article

Fiore AE, Fry A, Shay D, et al. Antiviral agents for the treatment and chemoprophylaxis of influenza—recommendations of the Advisory Committee on Immunization Practices (ACIP)

Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, 1600 Clifton Road, N.E., MS A-20, Atlanta, GA 30333, USA.
MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 01/2011; 60(1):1-24.
Source: PubMed

ABSTRACT

This report updates previous recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of antiviral agents for the prevention and treatment of influenza (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2008;57[No. RR-7]).This report contains information on treatment and chemoprophylaxis of influenza virus infection and provides a summary of the effectiveness and safety of antiviral treatment medications. Highlights include recommendations for use of 1) early antiviral treatment of suspected or confirmed influenza among persons with severe influenza (e.g., those who have severe, complicated, or progressive illness or who require hospitalization); 2) early antiviral treatment of suspected or confirmed influenza among persons at higher risk for influenza complications; and 3) either oseltamivir or zanamivir for persons with influenza caused by 2009 H1N1 virus, influenza A (H3N2) virus, or influenza B virus or when the influenza virus type or influenza A virus subtype is unknown; 4) antiviral medications among children aged <1 year; 5) local influenza testing and influenza surveillance data, when available, to help guide treatment decisions; and 6) consideration of antiviral treatment for outpatients with confirmed or suspected influenza who do not have known risk factors for severe illness, if treatment can be initiated within 48 hours of illness onset. Additional information is available from CDC's influenza website at http://www.cdc.gov/flu, including any updates or supplements to these recommendations that might be required during the 2010-11 influenza season. Health-care providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information. Recommendations related to the use of vaccines for the prevention of influenza during the 2010-11 influenza season have been published previously (CDC. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices [ACIP], 2010. MMWR 2010;59[No. RR-8]).

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    • "Although seasonal patterns of virus activity could orientate the etiological diagnosis, several viruses can be cocirculating at the same time throughout the year (Ruuskanen et al., 2011). Rapid etiological diagnosis of ARI improves patients' management , as it allows for appropriate and on-time antiviral therapy, which has demonstrated a reduction of complications, duration of symptoms, and hospital stay (D'Heilly et al., 2008; Fiore et al., 2011). Indeed, rapid diagnosis avoids the use of unnecessary antibiotics and ancillary diagnostic studies (Ferronato et al., 2012; Benito-Fernández et al., 2006). "
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    • "Future therapeutic developments may also increase the need for rapid combined RSV and influenza diagnostics. While antiviral treatment is already recommended for infants and children below the age of 2 years (Fiore et al., 2011), there are also several new antivirals in development for RSV-infected infants, children, and adults (Bawage et al., 2013; Geller et al., 2013; Tayyari and Hegele, 2012). The prospect of RSV antivirals or other treatment options, including immune modulators, will further increase the need for rapid diagnostics in the acute care setting (Hurwitz, 2011; Kimpen, 2002). "
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