What treatment is recommended for a patient diagnosed with Influenza A (Flu A) or Respiratory Syncytial Virus (RSV) infection?

From the Guidelines

For patients diagnosed with Influenza A (Flu A), oseltamivir (Tamiflu) 75mg twice daily for 5 days is the recommended treatment, initiated within 48 hours of symptom onset for maximum effectiveness, as per the latest guidelines from the American Academy of Pediatrics (AAP) 1.

Treatment Options for Flu A

• Oseltamivir is the preferred postexposure chemoprophylaxis for patients with influenza A and/or B, with a dosage of 75mg twice daily for 5 days for adults, and weight-based dosing for children 1.
• Baloxavir (Xofluza) is an alternative, given as a single dose based on weight (40mg for patients <80kg, 80mg for patients ≥80kg) 1.

Treatment Options for RSV

• Treatment is primarily supportive care, as there are no widely approved antivirals for most patients 1.
• Ribavirin may be considered in severely immunocompromised adults, although data are limited and its use is not widely recommended 1.
• The monoclonal antibody nirsevimab (Beyfortus) is used preventively in high-risk infants, but not for treatment of established RSV infection.

Supportive Care

• Rest, adequate hydration, and fever control with acetaminophen or ibuprofen are essential for both Flu A and RSV infections.
• Patients should monitor for worsening symptoms like difficulty breathing or dehydration.
• Antiviral treatment for influenza works by inhibiting viral replication, reducing symptom duration and severity, while supportive care helps maintain physiological function while the immune system fights the infection.

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. VIRAZOLE® (Ribavirin for Inhalation Solution, USP) is indicated for the treatment of hospitalized infants and young children with severe lower respiratory tract infections due to RSV.

The recommended treatment for a patient diagnosed with Influenza A (Flu A) is oseltamivir phosphate for oral suspension 2. The recommended treatment for a patient diagnosed with Respiratory Syncytial Virus (RSV) infection is ribavirin for inhalation solution (VIRAZOLE), but only for hospitalized infants and young children with severe lower respiratory tract infections due to RSV 3.

From the Research

Treatment for Influenza A (Flu A) or Respiratory Syncytial Virus (RSV) Infection

• The recommended treatment for Influenza A (Flu A) is oseltamivir, a neuraminidase inhibitor that can reduce the duration and severity of symptoms 4, 5, 6, 7.
• Oseltamivir is effective in treating influenza in adult populations, including the elderly and patients with chronic cardiac and/or respiratory disease 7.
• The standard dosage of oseltamivir is 75 mg twice daily for 5 days, but some studies suggest that a treatment duration of 10 days may be more effective in certain cases 6.
• Oseltamivir has also been shown to be effective in treating influenza in pediatric patients, including those with comorbidities such as asthma and gastrointestinal diseases 8.
• The use of oseltamivir in patients with RSV infection is not well established, and there is limited evidence to support its effectiveness in treating this condition.

Dosage and Administration

• The recommended dosage of oseltamivir for adults is 75 mg twice daily for 5 days 4, 5, 7.
• For pediatric patients, the recommended dosage is 2 mg/kg/dose administered twice daily for 5 days 8.
• Oseltamivir can be administered orally, and it is recommended to take it with food to reduce the risk of gastrointestinal side effects 4.

Efficacy and Safety

• Oseltamivir has been shown to be effective in reducing the duration and severity of influenza symptoms, as well as the risk of complications such as pneumonia and bronchitis 4, 7.
• Oseltamivir is generally well tolerated, with common side effects including nausea, vomiting, and diarrhea 4, 7, 8.
• The use of oseltamivir in patients with certain comorbidities, such as renal impairment, requires careful consideration and dose adjustment 6.