Reasonable Rascal
10-21-09, 21:08
Pediatric Recommendations for the Use of Antiviral Medications for 2009-10 Influenza Season
Early empiric treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who have:
o severe illness;
o evidence of clinical deterioration regardless of previous health;
o symptoms of lower respiratory tract involvement;
o illness requiring hospitalization.
In addition, early empiric outpatient treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who are at higher risk for complications including:
o Children younger than 2 years old (Please see below for special considerations for treatment or chemoprophylaxis of children younger than 1 year old);
o Children and adolescents with certain chronic medical or immunosuppressive conditions including:
§ Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus);
§ Disorders that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries; epilepsy, or other neuromuscular disorders);
§ Immunosuppression, including that caused by medications or by HIV;
o Pregnant adolescents and adolescents up to 2 weeks postpartum (including following pregnancy loss);
o Persons younger than 19 years old who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome;
o Children 2-4 years old are more likely to require urgent medical evaluation or hospitalization due to influenza compared with older children, although the risk is lower than for children less than 2 years old.
Children aged 2 years to 4 years without high risk conditions (see page 3) and with mild illness do not necessarily require antiviral treatment.
[Taken from Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season: http://www.cdc.gov/h1n1flu/recommendations.htm and from Recommendations for Use of Antiviral Medications for the Management of Influenza in Children and Adolescent for the 2009-2010 Season - Pediatric Supplement for Health Care Providers
http://www.cdc.gov/h1n1flu/recommendations_pediatric_supplement.htm
see also the oseltamivir package insert:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/]
Most children and adolescents who develop a mild illness consistent with uncomplicated influenza, or appear to be recovering from influenza, do not need antiviral medications for treatment. However, clinical judgment is always an essential part of treatment decisions. Assessment of a child’s or adolescent’s clinical presentation and underlying risk factors for influenza-related complications and death should guide medical therapy.
Early empiric treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who have:
o severe illness;
o evidence of clinical deterioration regardless of previous health;
o symptoms of lower respiratory tract involvement;
o illness requiring hospitalization.
In addition, early empiric outpatient treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who are at higher risk for complications including:
o Children younger than 2 years old (Please see below for special considerations for treatment or chemoprophylaxis of children younger than 1 year old);
o Children and adolescents with certain chronic medical or immunosuppressive conditions including:
§ Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus);
§ Disorders that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries; epilepsy, or other neuromuscular disorders);
§ Immunosuppression, including that caused by medications or by HIV;
o Pregnant adolescents and adolescents up to 2 weeks postpartum (including following pregnancy loss);
o Persons younger than 19 years old who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome;
o Children 2-4 years old are more likely to require urgent medical evaluation or hospitalization due to influenza compared with older children, although the risk is lower than for children less than 2 years old.
Children aged 2 years to 4 years without high risk conditions (see page 3) and with mild illness do not necessarily require antiviral treatment.
[Taken from Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season: http://www.cdc.gov/h1n1flu/recommendations.htm and from Recommendations for Use of Antiviral Medications for the Management of Influenza in Children and Adolescent for the 2009-2010 Season - Pediatric Supplement for Health Care Providers
http://www.cdc.gov/h1n1flu/recommendations_pediatric_supplement.htm
see also the oseltamivir package insert:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/]
Most children and adolescents who develop a mild illness consistent with uncomplicated influenza, or appear to be recovering from influenza, do not need antiviral medications for treatment. However, clinical judgment is always an essential part of treatment decisions. Assessment of a child’s or adolescent’s clinical presentation and underlying risk factors for influenza-related complications and death should guide medical therapy.