Influenza Update: Antivirals are an Important Part of New IDSA Flu Guidelines

Drug Topics JournalDrug Topics February 2019
Volume 163
Issue 2

Updated recommendations for the diagnosis, treatment, prevention, and outbreak management of seasonal influenza. 

Vaccination Administration

Just in time for this flu season, the Infectious Diseases Society of America (IDSA) has issued updated recommendations for healthcare professionals for the diagnosis, treatment, prevention, and outbreak management of seasonal influenza.

The new guidelines–the first update in 10 years–focus on three areas: adding groups to those at high risk for flu complications, recommending use of newer fast and accurate molecular tests to diagnose influenza, and prescribing antiviral medications for those at high risk even if they have been sick for more than two days.

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Andrew Pavia, MD, professor and chief of infectious diseases at the University of Utah in Salt Lake City and part of the IDSA committee updating the guidelines, notes the last recommendations were released before the 2009 H1N1 epidemic.

“Since 2008, we have really developed a lot of new evidence about when and where antivirals work,” Pavia tells Drug Topics. “It’s important to get the message out. They can be life-saving to those with high risk of complications. They are important to people with high risk whether they are hospitalized or not.”

The new guidelines include:

  • Additional High-risk groups  Pregnant women and those who have given birth within the last two weeks are among those considered at high risk for flu complications and should be tested and treated as soon as possible. Others added to the high-risk groups include people who are morbidly obese, those with neurological and neurodevelopmental disorders, those with weakened immune systems, nursing home residents, and Native Americans and Native Alaskans, who had a higher mortality rate during the 2009 pandemic.


  • Molecular testing Using highly accurate molecular tests that give results in 15 to 60 minutes instead of rapid-influenza diagnostic tests (RIDTs) that produce false negatives in at least 30% of outpatients with flu.
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