Use Antiviral Drugs for High-risk Influenza Patients

CDC, AAFP and Other Groups Offer Flu Treatment Tips

February 04, 2015 04:31 pm News Staff

This flu season, the CDC and several medical organizations -- including the AAFP -- are urging physicians and other health care professionals to help protect children younger than 2 and adults 65 and older by using antiviral drugs promptly when influenza is suspected in these patients.

[Anti Viral medicine pack with tablets scattered on table]

In a Jan. 29 "Dear Colleague" letter,(289 KB PDF) the groups say that flu activity in the United States is still high and likely will continue for weeks. They also point out that influenza A (H3N2) viruses remain the most commonly circulating strains to date and note that more hospitalizations and deaths occur in these two high-risk patient populations during seasons when H3N2 viruses predominate.

Even though the 2014-2015 vaccine has proven to be only 23 percent effective against H3N2 viruses, the CDC continues to recommend the vaccine for all eligible patients because it provides at least some protection against the H3N2 strain, and it protects against two or three other virus strains that could possibly circulate later in the season.

In the letter, the agency also recommends prompt antiviral treatment for severely ill and high-risk patients to reduce flu complications and deaths.

The letter offers a number of key points regarding antiviral drug use in high-risk patients:

  • Data indicate that antiviral drugs can reduce symptoms and prevent serious flu complications.
  • For high-risk patients, antiviral drugs can mean the difference between a milder illness and a hospital stay.
  • Antiviral drugs are under-utilized. A recent study showed that only 19 percent of high-risk outpatients who had the flu were treated with antiviral drugs.
  • All severely ill patients and those at high risk for serious complications in whom flu is suspected should be treated with flu antiviral drugs as soon as possible (i.e., without confirmatory testing).
  • Studies show that flu antiviral drugs work best for treatment when they are started within two days of illness onset. However, starting them later can still be helpful.
  • The CDC recommends three influenza antiviral drugs: oseltamivir (Tamiflu), zanamivir (Relenza) and the IV drug peramivir (Rapivab).