Contact Us
- 800–CDC–INFO
- (800-232-4636)
- 888–232–6348 (TTY)
- cdcinfo@cdc.gov
Indications for Use of Antiviral Agents for Seasonal Influenza (Treatment and Prevention)
On this page:
Treatment
Oseltamivir and zanamivir can reduce the duration of uncomplicated influenza A and B illness by approximately 1 day. Limited data suggest oseltamivir and zanamivir may also prevent serious influenza-related complications (e.g., bacterial or viral pneumonia or exacerbation of chronic diseases) in uncomplicated influenza. Evidence for the effectiveness of oseltamivir and zanamivir for treatment of influenza among persons who have been hospitalized because of influenza complications is limited. One observational study indicated that oseltamivir reduced mortality among hospitalized patients with laboratory-confirmed influenza.
The recommended duration of treatment with oseltamivir and zanamivir is 5 days.
NOTE: The text above was summarized from the 2008 ACIP recommendations.Prevention
The use of influenza antiviral medications is not a substitute for vaccination. However, clinical trial data indicates that antiviral medications are effective for the prevention and control of influenza, and use of these medications is important to consider in certain circumstances. Community studies of healthy adults indicate that oseltamivir and zanamivir are similarly effective in preventing febrile, laboratory-confirmed influenza illness (efficacy: zanamivir, 84%; oseltamivir, 82%). Both medications also have been reported to prevent influenza illness among persons with an ill household member diagnosed with influenza. In institutional settings, one 6-week study of oseltamivir prophylaxis among nursing home residents reported a 92% reduction in influenza illness.
When determining the timing and duration for administering oseltamivir or zanamivir for prevention, factors related to cost, compliance, and potential side effects should be considered. To be maximally effective as prophylaxis, the drug must be taken each day for the duration of influenza activity in the community.
NOTE: The text above was summarized from the 2008 ACIP recommendations.Consider Use of the Neuraminidase Inhibitors in These People:
People at High Risk Who Are Vaccinated After Influenza Activity Has Begun
Development of antibodies in adults after vaccination takes approximately 2 weeks. Therefore, when influenza vaccine is administered after influenza activity in a community has begun, chemoprophylaxis should be considered for persons at higher risk for influenza complications during the time from vaccination until immunity has developed. Children aged younger than 9 years who receive influenza vaccination for the first time might require as much as 6 weeks of chemoprophylaxis (i.e., chemoprophylaxis until 2 weeks after the second dose when immunity after vaccination would be expected). Persons at higher risk for complications of influenza still can benefit from vaccination after community influenza activity has begun because influenza viruses might still be circulating at the time vaccine-induced immunity is achieved.
People Who Provide Care to Those at High Risk
To reduce the spread of virus to persons at high risk, chemoprophylaxis during peak influenza activity can be considered for unvaccinated persons who have frequent contact with persons at high risk. Persons with frequent contact might include employees of hospitals, clinics, and chronic-care facilities, household members, visiting nurses, and volunteer workers. If an outbreak is caused by a strain of influenza that might not be covered by the vaccine, chemoprophylaxis can be considered for all such persons, regardless of their vaccination status.
People Who Have Immune Deficiencies
Chemoprophylaxis can be considered for persons at high risk who are more likely to have an inadequate antibody response to influenza vaccine. This category includes persons infected with HIV, particularly those with advanced HIV disease. No published data are available concerning possible efficacy of chemoprophylaxis among persons with HIV infection or interactions with other drugs used to manage HIV infection. Such patients should be monitored closely if chemoprophylaxis is administered.
Other People
Chemoprophylaxis throughout the influenza season or during increases in influenza activity within the community might be appropriate for persons at high risk for whom vaccination is contraindicated, or for whom vaccination is likely to be ineffective. Health-care providers and patients should make decisions regarding whether to begin chemoprophylaxis and how long to continue it on an individual basis.
NOTE: The text above is taken from Prevention & Control of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP) 2008. MMWR 2008 Jul 17; Early Release:1-60. (Also available as PDF, 586K).
- Page last updated August 29, 2008
- Content Source: Coordinating Center for Infectious Diseases (CCID)
- National Center for Immunization and Respiratory Diseases (NCIRD)
