Home Care Discharge Instructions for Influenza
Discharge Readiness Criteria
Patients should be reviewed within 24 hours before discharge and must have fewer than two of the following unstable clinical factors to be safely discharged home: 1
- Temperature ≤37.8°C
- Heart rate ≤100 beats/min
- Respiratory rate ≤24 breaths/min
- Systolic blood pressure ≥90 mmHg
- Oxygen saturation ≥90%
- Ability to maintain oral intake
- Normal mental status
If two or more unstable factors persist, the patient should remain hospitalized for continued monitoring and supportive care. 1
Antiviral Medication Instructions
Complete the full 5-day course of oseltamivir 75 mg twice daily, even if symptoms improve earlier. 1
- If creatinine clearance is <30 mL/min, the dose should be reduced to 75 mg once daily 1
- Take with food to minimize gastrointestinal side effects 2
- Oseltamivir shortens illness duration by approximately 24 hours and may reduce complications 1, 3
Warning Signs Requiring Immediate Medical Attention
Return to the emergency department or contact your physician immediately if any of the following develop: 1, 4, 5
- Worsening respiratory symptoms: increasing shortness of breath, chest pain, or difficulty breathing 4, 3
- Recrudescent fever: fever that returns or persists beyond 48-72 hours after starting antiviral therapy 1, 4
- Productive cough with purulent (yellow/green) sputum: suggests possible bacterial superinfection 1, 4
- Altered mental status: confusion, severe weakness, or inability to stay awake 1
- Inability to tolerate oral fluids: persistent vomiting or severe dehydration 1
- Oxygen desaturation symptoms: bluish lips or fingernails, severe breathlessness 4, 3
Supportive Care at Home
Maintain adequate hydration and nutrition, as high fever increases fluid loss and metabolic demands. 1, 4
- Drink at least 8-10 glasses of water or clear fluids daily 1
- Use acetaminophen or ibuprofen for fever and body aches as needed 2
- Rest is essential for recovery; avoid strenuous activity until fully recovered 2, 6
Monitor your temperature, breathing rate, and overall condition daily. 1
Antibiotic Use: Critical Guidance
Do not take antibiotics unless specifically prescribed by your physician for confirmed bacterial complications. 1, 3
- Previously healthy adults with uncomplicated influenza do not require antibiotics 1, 3
- Antibiotics are only indicated if you develop worsening symptoms after initial improvement, suggesting bacterial superinfection such as pneumonia 1, 4
- If prescribed antibiotics (typically co-amoxiclav or clarithromycin), complete the full course as directed 1
Infection Control Measures
Practice strict respiratory hygiene to prevent transmission to household members: 6, 7
- Wear a face mask when around others for at least 5-7 days after symptom onset 6
- Cover coughs and sneezes with a tissue or elbow 6
- Wash hands frequently with soap and water for at least 20 seconds 6
- Avoid close contact with high-risk individuals (elderly, young children, immunocompromised) until fever-free for 24 hours without medication 6, 7
- Disinfect frequently touched surfaces daily 6
Follow-Up Arrangements
A follow-up clinical review should be scheduled if you experienced significant complications or worsening of underlying chronic disease. 1
- Contact your primary care physician within 3-7 days if you had pneumonia, required oxygen therapy, or have chronic conditions (COPD, heart disease, diabetes) 1, 4
- The hospital team is responsible for arranging this follow-up plan with you and your general practitioner 1
Reassessment within 24-48 hours (by telephone or in-person) is recommended to confirm improvement. 4, 3
- If there is no improvement or clinical worsening, a chest radiograph and possible hospital readmission may be necessary 4, 3
Expected Recovery Timeline
Most patients recover within 7-10 days, though cough and fatigue may persist for 2-3 weeks. 2, 6