WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses
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(updated from May 2009 and August 2009 versions)
The purpose of this document is to provide a basis for advice to clinicians on the use of the currently available antivirals for patients presenting with illness due to influenza virus infection as well the potential use of the medicines for chemoprophylaxis. The document addresses specifically the two neuraminidase inhibitors oseltamivir and zanamivir, and the two M2 inhibitors amantadine and rimantadine. It includes recommendations on the use of some other potential pharmacological treatments. While the focus of the document is on management of patients with pandemic influenza (H1N1) 2009 virus infection, the document includes guidance on the use of the antivirals for other seasonal influenza virus strains, and for infections due to novel influenza A virus strains. WHO recommends that country and local public health authorities issue local guidance for clinicians from time to time that places these recommendations in the context of epidemiological and antiviral susceptibility data on the locally circulating influenza strains.
This guidance updates and replaces the recommendations published in August 2009. This document will again be reviewed in September 2010 and, if necessary, updated.
Key changes to the guidelines are:
- simplification of recommendations as pandemic influenza virus has become the predominant influenza virus worldwide.
- specific guidance for the treatment of young children from birth, including guidance on dose and formulation.
- additional guidance for treatment or chemoprophylaxis of patients with severe immunosuppression.
- consideration of a wider range of investigational, regional or adjunctive treatments.
- specific contraindications for some medicines.