What is the treatment for Influenza (Influ B)?

From the Guidelines

Influenza B treatment should be initiated as soon as possible with antiviral medications, such as oseltamivir (Tamiflu), for patients who are hospitalized, have severe or progressive illness, or are at high risk of complications, including those with chronic medical conditions, immunocompromised patients, children younger than 2 years, adults ≥65 years, pregnant women, and those within 2 weeks postpartum 1.

Patient Selection for Antiviral Treatment

The decision to treat influenza B with antivirals should be based on the patient's risk of complications, severity of illness, and time since symptom onset.

• Patients who are hospitalized with influenza, regardless of illness duration prior to hospitalization, should be treated with antivirals 1.
• Outpatients with severe or progressive illness, regardless of illness duration, should also be treated with antivirals 1.
• Additionally, outpatients who are at high risk of complications from influenza, including those with chronic medical conditions and immunocompromised patients, should be treated with antivirals 1.

Antiviral Medications

The first-line antiviral medication for influenza B is oseltamivir (Tamiflu), with a standard adult dosage of 75 mg twice daily for 5 days, while children receive weight-based dosing (30-75 mg twice daily) 1.

• Alternative antivirals include zanamivir (Relenza), peramivir (Rapivab), or baloxavir marboxil (Xofluza).

Supportive Care

Supportive care is equally important in the management of influenza B, including:

• Rest
• Adequate hydration
• Fever control with acetaminophen or ibuprofen Patients should isolate until 24 hours after fever resolves to prevent transmission.

Benefits of Antiviral Treatment

Antivirals work by inhibiting viral replication, reducing symptom duration and severity by 1-2 days 1.

• While most healthy individuals recover without specific treatment, antivirals are particularly important for high-risk patients to prevent complications like pneumonia.

From the FDA Drug Label

Oseltamivir phosphate for oral suspension is indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. The recommended oral dosage of oseltamivir phosphate for oral suspension for treatment of influenza in adults and adolescents 13 years and older is 75 mg twice daily (12. 5 mL of oral suspension twice daily) for 5 days. RELENZA (zanamivir) inhalation powder is indicated for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients aged 7 years and older who have been symptomatic for no more than 2 days.

The treatment for Influenza (Influ B) is:

• Oseltamivir (PO): 75 mg twice daily for 5 days in adults and adolescents 13 years and older 2
• Zanamivir (INH): for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients aged 7 years and older who have been symptomatic for no more than 2 days 3 Key considerations:
• Treatment should be initiated within 48 hours of symptom onset
• Dosage adjustments may be necessary for patients with renal impairment 2

From the Research

Treatment Options for Influenza B

The treatment for Influenza B includes the use of antiviral agents, such as neuraminidase inhibitors, which are effective against both influenza A and B 4, 5, 6, 7.

• The decision to use these agents should be based on factors such as the age of the patient, antiviral activity, side effect profile, ease of administration, drug interactions, and cost 4.
• Treatment with antiviral agents should be started within 48 hours of symptom onset, and ideally within 24 hours, to be effective in reducing the duration and severity of symptoms 4, 8, 5, 6, 7.
• Antiviral agents available for the treatment of influenza B include zanamivir and oseltamivir, which are well-tolerated and active against both influenza A and B without the development of resistance 4, 5, 6, 7.

Considerations for Treatment

• The use of antiviral agents should be considered in patients who present within 48 hours of symptom onset, especially those at high risk of complications, such as young children, the elderly, pregnant and post-partum women, patients with co-morbidities, and the immunocompromised 8, 6.
• Treatment should be continued only in patients with a confirmed diagnosis of influenza, and laboratory testing may be useful in hospitalized patients or those for whom a confirmed diagnosis will change treatment decisions 8.
• The benefit of treatment is greatest when antiviral therapy is started within 24 hours of symptom onset, and may decrease the risk of serious complications, such as pneumonia or hospitalization secondary to influenza 4, 8, 6.