What is the treatment for Influenza B?

From the Guidelines

The treatment for Influenza B is oseltamivir (Tamiflu), which is the preferred antiviral drug for management of illness caused by influenza virus infections, including Influenza B, due to its cumulative experience, relative cost, and ease of administration 1.

Antiviral Therapy Options

• Oseltamivir (Tamiflu): the antiviral drug of choice for the management of illness caused by influenza virus infections, including Influenza B, with a recommended dose that can be found in Table 6 in the policy statement (www.pediatrics.org/cgi/doi/10.1542/peds.2024-068507) 1.
• Zanamivir (Relenza): an acceptable alternative for patients 7 years and older who do not have chronic respiratory disease, with a similar efficacy to oseltamivir in preventing influenza-related hospitalization or death 1.
• Peramivir (Rapivab): a single dose of intravenous peramivir is approved for the treatment of acute uncomplicated influenza in ambulatory children 6 months and older who have been symptomatic for no more than 2 days, with similar clinical outcomes to oseltamivir in children with influenza B 1.
• Baloxavir marboxil (Xofluza): approved for treatment of acute uncomplicated influenza in otherwise healthy adults, with better efficacy than oseltamivir in the treatment of influenza B in some studies, but limited availability of the oral suspension formulation for children weighing less than 20 kg 1.

Patient Selection for Antiviral Treatment

Antiviral treatment should be started as soon as possible for patients with documented or suspected influenza who meet certain criteria, including:

• Hospitalized patients with influenza, regardless of illness duration prior to hospitalization 1.
• Outpatients with severe or progressive illness, regardless of illness duration 1.
• Outpatients who are at high risk of complications from influenza, including those with chronic medical conditions and immunocompromised patients 1.
• Children younger than 2 years and adults ≥65 years 1.
• Pregnant women and those within 2 weeks postpartum 1.

From the Research

Treatment Options for Influenza B

The treatment for Influenza B includes the use of antiviral agents, which can help reduce the duration and severity of symptoms. Some of the key treatment options are:

• Zanamivir and oseltamivir, which are newer agents indicated for the treatment of both influenza A and B 2
• Amantadine and rimantadine, which are older antiviral agents that have been used in the past, but have limitations due to adverse effects and the development of resistance 2, 3
• Oseltamivir, which has been shown to be effective in reducing the duration of symptomatic illness and hastening the return to normal levels of activity when initiated promptly in patients with naturally acquired influenza 4

Key Considerations for Treatment

Some key considerations for the treatment of Influenza B include:

• Antiviral agents must be used within 48 hours of the onset of influenza symptoms to be effective 2, 3
• Early identification and diagnosis of influenza illnesses are crucial for effective treatment 3
• The use of antiviral agents can help reduce the risk of severe complications and the use of antibacterials 2, 4
• Neuraminidase inhibitors, such as oseltamivir, have been shown to be effective against both influenza A and B, without the development of resistance 3, 5

Special Considerations for High-Risk Populations

For high-risk populations, such as the elderly or those with chronic cardiac or respiratory disease, the use of antiviral agents can be particularly important. Some key considerations for these populations include:

• The use of oseltamivir has been shown to be effective in reducing the risk of illness in household contacts of infected persons when administered within 48 hours of symptom onset in the infected person 4
• Antiviral prophylaxis and treatment with amantadine and rimantadine have been used in the past, but have limitations due to adverse effects and the development of resistance 3
• The newer antivirals, such as zanamivir and oseltamivir, are equally effective and have the advantage of being well tolerated and active against both influenza A and B without the development of resistance 3