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Timing, nature of influenza A (H1N1) antiviral treatment remains up for debate
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The recommended 48-hour window in which to intiate antiviral therapy for the treatment of influenza A (H1N1) remains an ongoing source of concern for clinicians, according to opinions expressed at a press conference at the 47th Annual Meeting of the Infectious Diseases Society of America, held this week in Philadelphia.
Stephen Redd, MD, chief of the Air Pollution and Respiratory Health Branch in th National Center for Environmental Health at CDC, provided an overview of the epidemiology of the disease in the context of this issue; Arnold Monto, MD, professor of epidemiology at the University of Michigan School of Public Health, attempted to clear up misconceptions regarding influenza A (H1N1) treatment.
“It is important to note that many seem to think that 48 hours is the threshold for treatment,” Redd said. “[Some assume that] if you cannot start treatment by that point, you should not treat at all; that is really not the message we want to send.”
Monto said that the use of antiviral therapy as post-exposure prophylaxis has contributed to the confusion.
Monto also discussed the 48-hour mark as the recommended time point for whether to administer treatment or not. “The take-home message about when to treat with the current recommendations is that you might be delayed with treatment because the case may look like ordinary H1N1 and not one of the so-called more severe cases,” he said. “But with the shedding data that we now know about, you can still get an effect later on in treatment. So do not stick with the package insert and the two days.”