Tamiflu and Relenza should be given EARLY in flu to certain pediatric groups -- CDC

While the recommendation of NOT giving Tamiflu (oseltamivir) and Relenza (zanamivir) has been widely publicized for routine cases of influenza, the CDC has recommended giveing these agents early, within 47 hours of the onset, for some groups:

1) severe illness
2) evidence of clinical deterioration regardless of previous health
3) symptoms of lower respiratory tract involvement
4) illness requiring hospitalization


These antiviral treatments SHOULD NOT WAIT for laboratory confirmation of influenza because waiting for laboratory testing results can delay treatment.

Infants under one year of age have a much higher death rate from H1N1 flu and the FDA has authorized oseltamivir for the treatment of 2009 H1N1 influenza infections in children younger than 1 year old, under an Emergency Use Authorization.

Early outpatient empiric treatment with Tamiflu and Relenza should be considered for children and adolescents who:

1) Children younger than 2 years old
2) Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus)
3) Disorders that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries; epilepsy, or other neuromuscular disorders);
4) Immunosuppression, including that caused by medications or by HIV;
5) Pregnant adolescents and adolescents up to 2 weeks postpartum
6) Persons younger than 19 years old who are receiving long-term aspirin therapy,

http://www.cdc.gov/h1n1flu/recommendations_pediatric_supplement.htm