The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.
The updated recommendations include guidance for clinicians about the following:
▸ Treating children younger than age 1 year. Oseltamivir (Tamiflu) is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6–11 months, 20 mg twice daily for children aged 3–5 months, and 12 mg twice daily for children younger than 3 months.
The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6–11 months, and 20 mg once daily for children aged 3–5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical.
The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.
▸ Dispenser measurements. Clinicians and pharmacists are cautioned that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use mg and match those currently recommended by the CDC for treatment or chemoprophylaxis against H1N1 infection, but the prescription instructions may be listed in mL or tsp, which can lead to dosing errors.
▸ Patients with neuromuscular or neurocognitive disorders. The revised recommendations for individuals who might benefit most from early treatment with antiviral therapy include patients with disorders that can increase the risk for aspiration, such as spinal cord injuries, seizure disorders, cognitive dysfunction, and other neuromuscular disorders, plus any disorders that “can compromise respiratory function or the handling or respiratory secretions.”
The CDC stated that its guidance will be updated as needed. For the latest information on the CDC's flu recommendations, visit cdc.govflu.gov