Issue: October 2009
October 01, 2009
1 min read

CDC updates guidelines on antivirals for flu

Issue: October 2009
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CDC officials issued new guidelines on antiviral medication for influenza, which advise clinicians to consider having an antiviral prescription on hold for those patients who may be at high risk for influenza complications, and emphasized the importance of only using these medications in these patients.

Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases at the CDC, said the guidelines are intended to shorten the time period when antivirals are prescribed; data have shown that administering antivirals in the first 48 hours to high-risk patients can have an effect on disease severity.

The guidelines, found at, are a revision to guidelines issued in May. At that time, CDC officials said that antivirals may be used to quell disease spread in some pediatric populations. Schuchat said health officials rethought that guideline as more data have shown the disease to be less severe in children older than 5 years.

“Instead of emphasizing preventive use of antivirals, providers may want to consider watchful waiting in some patients to see if fever develops or if respiratory symptoms occur,” Schuchat said.

For hospitalized patients and those patients with underlying health conditions such as asthma, heart disease and respiratory problems, CDC officials are recommending prompt treatment with antivirals. Schuchat said clinicians should not wait for rapid testing to identify what type of respiratory virus is causing illness before initiating antivirals in these patients. So far, only a “handful” of cases of oseltamivir-resistant H1N1 viruses have been reported around the world, but that may increase if antivirals are overprescribed, Schuchat said.

“A key point from our guidance is that most children, adolescents and adults do not need antiviral medicines,” Schuchat said. “If all these people take antivirals, things may get worse.”

As expected, cases of the novel influenza A (H1N1) are starting to rise as children return to school. Schuchat said that on the Friday before Labor Day, about 25,000 students in Georgia, Alabama, Indiana, Missouri and Tennessee had been sent home due to reports of the novel influenza in certain school districts.

Health officials are watching the novel influenza situation in the southern hemisphere and have noted that the virus has not changed, which they said is good news because the vaccines in development for the novel influenza would be a match for the circulating strain. – by Colleen Zacharyczuk