Updated recommendations issued on antiviral agents for influenza

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) released updated recommendations last week for antiviral treatment in patients with confirmed or suspected influenza.

The recommendations address use of antiviral agents for influenza prevention and treatment and include the following changes from previous recommendations:

• Early antiviral treatment is recommended for patients with suspected influenza or clinically or laboratory-confirmed influenza who have severe, complicated, or progressive illness or require hospitalization, and for outpatients with confirmed or suspected influenza at higher risk for complications because of their age or underlying medical conditions.
• Oseltamivir and zanamivir are recommended because almost all currently circulating influenza virus strains are sensitive to them.
• Amantadine and rimantadine should not be used because of high resistance among circulating influenza A viruses.
• Oseltamivir may be used for treatment or chemoprophylaxis in infants younger than 1 year when indicated.
• Antiviral treatment within 48 hours of illness onset may be considered on the basis of clinical judgment for any outpatient with confirmed or suspected influenza but no known risk factors for severe illness.
• Clinicians should monitor their local data on antiviral resistance, since patterns can change over time.

The new recommendations, which were published Jan. 21 in the CDC's Morbidity and Mortality Weekly Report , are available online.