Auburn pharmacy researcher recommends antivirals as key defense this flu season

Published: February 15, 2018
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The Centers for Disease Control and Prevention reports the flu is "widespread" across the United States with 48 states reporting widespread activity. With this year’s strain having such an impact, Dr. Marilyn Bulloch, a clinical faculty member in Auburn University’s Harrison School of Pharmacy, suggests the use of antivirals in prevention and treatment.

Both the influenza A and influenza B viruses are prominent this year with nearly 15,000 flu-related hospitalizations since October. Vaccines are available through pharmacists and physicians and have shown some resistance to this year’s strain. According to Bulloch, antivirals have shown to be an effective complement to the flu vaccine.

"Anyone who is diagnosed with the flu and does not have a reason to not seek therapy can receive antivirals," said Bulloch. "Studies have shown that they decrease symptoms by several days. This season, the virus has been particularly virulent, and a few days without symptoms such as fever, gastrointestinal upset and muscle aches may help reduce complications of the flu such as hospitalizations."

Current options include Tamiflu (oseltamivir) which is available orally and Relenza (zanamivir), which is an inhalation product that comes as a Diskhaler. For children, Zanamivir is approved for treatment in those over seven and prevention in children over five.

Oseltamivir is historically the most common antiviral and can be used for treatment at any age over two-weeks old and for the prevention of influenza in patients over three months of age. There is a one-dose IV product available but it is unknown how many hospitals and urgent care centers have it available. Only Tamiflu is recommended for patients who are hospitalized.

There are certain populations that antivirals are strongly recommended this flu season. They include: children over two and adults over 65, those with compromised immune systems, children on long-term aspirin therapy, pregnant women and women who gave birth less than two weeks before influenza diagnosis, American Indians and obese patients with a BMI over 40.

Treatment is recommended for patients with certain chronic conditions involving the lung, heart, kidney or liver; those with diabetes, sickle cell, seizures or a history of stroke should also seek antiviral treatment. While it is highly suggested for those populations, anyone with a chronic medical treatment should discuss with their physician the benefit and need for antiviral treatment.

"Treatment is most effective when it is started soon after symptom developed, ideally within 48 hours. However, there is some data suggesting patients may still benefit even if treatment is delayed as long as 72 hours after symptom development," said Bulloch. "Antivirals are recommended for anyone with a severe case of influenza, whose illness is complicated by other issues such as pneumonia, and for those whose influenza does not start to resolve with time."

The good news for those who may come into contact with the flu is that resistance to the medications used to treat it has been almost non-existent this season.

While treatments have been effective, prevention is still key and those susceptible to the flu should be prepared.

"People who are exposed to those with diagnosed influenza, including household contacts, should strongly consider getting antivirals for the prevention of influenza rather than waiting to become infected," said Bulloch.

For more information on the flu this season, visit www.cdc.gov/flu/.

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