Monday, June 29, 2009

CDC updates guidace on antivirals (slightly)


"Jun 25, 2009 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) today at the Advisory Committee on Immunization Practices meeting in Atlanta issued updated guidelines for treatment of influenza, including novel H1N1, suggesting basing antiviral selection on laboratory test results when possible.

The new guidance appears to be aimed at preventing the inadvertent prescription of oseltamivir (Tamiflu) for seasonal H1N1 infections, which have shown extensive resistance to oseltamivir in the United States and other parts of the world. The update was provided by CDC spokesman Tom Skinner.

According to the CDC update, only patients who test positive for influenza A/H3N2, pandemic H1N1, or B should receive oseltamivir. Zanamivir (Relenza) is preferred for patients who test positive for seasonal H1N1 influenza.

If a laboratory test is not performed or the test is negative but clinical suspicion remains, the preferred treatment is zanamivir or a combination of oseltamivir and rimantadine, which is an older drug of the adamantine class of antivirals. If testing indicates influenza A or unspecified influenza, the preferred treatment is also zanamivir or a combination of oseltamivir and rimantadine.

As with its earlier recommendation for novel H1N1 treatment, the CDC emphasized in today's updated guidance that treatment should be started as soon as possible after illness onset.

The CDC added a few more specifics to the list of people for whom antiviral treatment should be considered to include those who are hospitalized with influenza, have influenza with viral or bacterial pneumonia, or have influenza with a higher risk for complications, regardless or illness severity."

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