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​​ Influenza: Outpatient Management

 
First Line
Second Line
Antimicrobial
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 Oseltamivir

 
 
Dose
75mg every 12 hours
Route
PO
Duration
5 days

 

Renal Impairment (dose adjustments based on renal drug database)

Creatinine clearance
Recommended treatment dose (5 day course)
>30ml/min
75mg TWICE a day
11-30ml/min
75mg ONCE daily
<10ml/min
75mg STAT
Haemodialysis
30mg STAT then 30mg THREE times a WEEK after each HD session
Peritoneal dialysis
30mg ONCE weekly
Haemo(dia)filtration
1-1.8L/hr exchange rate
30mg ONCE a day
Haemo(dia)filtration
1.9-3.6 L/hr exchange rate
30mg TWICE a day
Haemo(dia)filtration
>3.6 L/hr exchange rate
75mg TWICE a day

 

Additional Information
  • ​Treatment only indicated for individuals in a risk group for influenza complications (see below) and have symptoms for less than 48 hours.
  • Outpatient management includes patients who have been assessed and subsequently discharged from ED/AMU.
  • Laboratory confirmation of respiratory virus infection (Nose and Throat Swabs) is not required.
  • Zanamivir may be used second line in immunocompromised patients, for further information see treatment gui​delines.Antiviral Treatment and Prophylaxis of Influenza v1.1.pdfAntiviral Treatment and Prophylaxis of Influenza v1.1.pdf
Risk groups for complicated influenza are people with:
  Neurological, hepatic, renal, pulmonary and chronic cardiac disease.
  Diabetes mellitus.
  Age over 65 years.
  Pregnancy (including up to two weeks post-partum).
  Morbid obesity (BMI >40).
•  Severe immunosuppression such as severe primary immunodeficiency, current or recent (within six months) chemotherapy or radiotherapy for malignancy, Solid organ transplant recipients on immunosuppressive therapy, bone marrow transplant recipients currently receiving immunosuppressive treatment or within 12 months of receiving immunosuppression, patients currently receiving high dose systemic corticosteroids (equivalent to ≥40 mg prednisolone per day for >1 week) and for at least three months after treatment has stopped, HIV infected patients with severe immunosuppression (CD4<200/μl or <15% of total lymphocytes), patients currently or recently (within six months) on other types of highly immunosuppressive therapy.​