| Patient group |
Treatment line
| Treatmentshow all |
|
pregnant
| 1st |
- supportive care + antipyretics + antiviral therapy
-
-
Oral fluids and antipyretics should be given. Fever should be treated promptly because of the association between fever and adverse pregnancy outcomes. The drug of choice is paracetamol. Patients <18 years of age should not take aspirin-containing medications, because of the risk of Reye's syndrome.
-
Antiviral therapy should be given as soon as possible. Because of its systemic activity, the drug of choice is oseltamivir.
-
Treatment course: 5 days.
Primary Options
paracetamol
:
500-1000 mg orally every 4-6 hours when required, maximum 4000 mg/day
and
oseltamivir
:
75 mg orally twice daily
|
|
non-pregnant adults: previously healthy
| 1st |
- supportive care + antipyretics
-
Primary Options
paracetamol
:
children: 10-15 mg/kg orally every 4-6 hours when required, maximum 90 mg/kg/day; adults: 500-1000 mg orally every 4-6 hours when required, maximum 4000 mg/day
OR
ibuprofen
:
children: 10 mg/kg orally every 6-8 hours when required, maximum 30 mg/kg/day; adults: 300-400 mg orally every 6-8 hours when required, maximum 2400 mg/day
|
|
with severe symptoms
|
|
- antiviral therapy
-
-
Patients with severe symptoms, including those requiring admission to the hospital, should receive treatment with antiviral agents. Although treatment is most effective when started within 48 hours of symptom onset, patients may still benefit if it is started beyond this time.
-
Because zanamivir is inhaled, oseltamivir is the preferred treatment for patients with significant respiratory problems.
-
Treatment course: 5 days.
Primary Options
oseltamivir
:
75 mg orally twice daily
OR
zanamivir
:
10 mg (2 puffs) inhaled twice daily
|
|
non-pregnant adults: high risk of influenza complications
| 1st |
- supportive care + antipyretics + antiviral therapy
-
-
Adults at high risk for complications include: age >65 years; residents of nursing and care homes; immunocompromised patients; patients with chronic pulmonary disease, chronic CVD, active malignancy, chronic renal disease, chronic hepatic disease, haematological disease, or diabetes; patients on long-term corticosteroids; patients with neurological and neurodevelopment conditions; patients aged <19 years who are receiving long-term aspirin therapy; American Indians/Alaska Natives; patients who are morbidly obese (i.e., BMI ≥40); and malnourished patients.
-
Oral fluids and antipyretics should be given, and antiviral therapy should be given as soon as possible.
-
Because zanamivir is inhaled, oseltamivir is the preferred treatment for patients with significant respiratory problems.
-
Treatment course: 5 days.
Primary Options
paracetamol
:
500-1000 mg orally every 4-6 hours when required, maximum 4000 mg/day
or
ibuprofen
:
300-400 mg orally every 6-8 hours when required, maximum 2400 mg/day
-- AND --
oseltamivir
:
75 mg orally twice daily
or
zanamivir
:
10 mg (2 puffs) inhaled twice daily
|
|
children <5 years: previously healthy
| 1st |
- supportive care + antipyretics
-
Primary Options
paracetamol
:
10-15 mg/kg orally every 4-6 hours when required, maximum 90 mg/kg/day
|
|
symptom onset within past 48 hours or severe disease
|
|
- antiviral therapy
-
-
Children <5 years of age are at increased risk for complications, and antiviral therapy with oseltamivir is recommended for symptom onset within 48 hours.
-
In more severe cases (with severe symptoms or if admission to the hospital is required), active treatment with antiviral agents is recommended even if symptom onset is >48 hours.
-
For children <1 year of age, the safety of oseltamivir is unknown, although the available data suggest that oseltamivir has a relatively low rate of serious adverse events in this age group.
-
Zanamivir is not recommended for this age group.
-
Treatment course: 5 days.
Primary Options
oseltamivir
:
children <12 months of age: 3 mg/kg orally twice daily; children ≥12 months of age and ≤15 kg: 30 mg orally twice daily; children ≥12 months of age and 16-23 kg: 45 mg orally twice daily; children ≥12 months of age and 24-40 kg: 60 mg orally twice daily; children ≥12 months of age and >40 kg: 75 mg orally twice daily
|
|
children ≥5 years: previously healthy
| 1st |
- supportive care + antipyretics
-
Primary Options
paracetamol
:
10-15 mg/kg orally every 4-6 hours when required, maximum 90 mg/kg/day
|
|
with severe symptoms
|
|
- antiviral therapy
-
-
Patients with severe symptoms, including those requiring admission to the hospital, should receive treatment with antiviral agents. Although treatment is most effective when started within 48 hours of symptom onset, patients may still benefit if it is started beyond this time.
-
Antiviral therapy should be given as soon as possible. Zanamivir is inhaled, so oseltamivir is the preferred treatment for patients with significant respiratory problems.
-
Treatment course: 5 days.
Primary Options
oseltamivir
:
children ≥12 months of age and ≤15 kg: 30 mg orally twice daily; children ≥12 months of age and 16-23 kg: 45 mg orally twice daily; children ≥12 months of age and 24-40 kg: 60 mg orally twice daily; children ≥12 months of age and >40 kg: 75 mg orally twice daily
OR
zanamivir
:
children ≥5 years of age: 10 mg (2 puffs) inhaled twice daily
|
|
children: high risk of influenza complications
| 1st |
- supportive care + antipyretics + antiviral therapy
-
-
Children at high risk for complications include those with developmental disabilities and chronic medical conditions, particularly chronic neurological or neuromuscular and congenital metabolic disorders.
-
Oral fluids and antipyretics should be given. Children should not be given aspirin-containing medications, because of the risk of Reye's syndrome.
-
Antiviral therapy should be given as soon as possible. Zanamivir is inhaled, so oseltamivir is the preferred treatment for patients with significant respiratory problems. Zanamivir is not recommended for children <5 years of age.
-
Treatment course: 5 days.
Primary Options
paracetamol
:
10-15 mg/kg orally every 4-6 hours when required, maximum 90 mg/kg/day
-- AND --
oseltamivir
:
children <12 months of age: 3 mg/kg orally twice daily; children ≥12 months of age and ≤15 kg: 30 mg orally twice daily; children ≥12 months of age and 16-23 kg: 45 mg orally twice daily; children ≥12 months of age and 24-40 kg: 60 mg orally twice daily; children ≥12 months of age and >40 kg: 75 mg orally twice daily
or
zanamivir
:
children ≥5 years of age: 10 mg (2 puffs) inhaled twice daily
|
