Patients admitted to hospital with suspected or confirmed influenza require prompt evaluation and early antiviral treatment. Evidence supports initiating therapy as soon as possible in this inpatient setting.

Clinical Scenario

This protocol addresses patients who are hospitalized with suspected or confirmed influenza. Early antiviral therapy is recommended regardless of the time since symptom onset, and treatment should not be delayed while awaiting confirmatory results.

Treatment Approach

The primary approach centres on oral or enterically administered antiviral therapy initiated as early as possible. For patients who are unable to tolerate or absorb the standard oral route — for example due to gastrointestinal complications — an intravenous antiviral alternative may be considered. The complete regimen, including alternative options, dosing adjustments, and the full clinical decision algorithm, is available in the structured protocol.

Treatment Goals

The primary clinical targets are shortening the duration of fever and influenza illness symptoms, with resolution of fever and symptoms expected by the end of the treatment course.

References

For hospitalized patients with suspected or confirmed influenza, initiation of antiviral treatment with oral or enterically administered oseltamivir is recommended as soon as possible.
For hospitalized patients who cannot tolerate or absorb oral or enterically administered oseltamivir because of suspected or known gastric stasis, malabsorption, or gastrointestinal bleeding, intravenous peramivir may be considered.
Daily dosing for a minimum of 5 days was used in clinical trials of hospitalized patients with influenza.
Clinical trials and observational data show that early antiviral treatment can shorten the duration of fever and illness symptoms, and may reduce the risk of some complications from influenza (e.g., otitis media in young children, pneumonia, and respiratory failure).

DOI: 10.1093/cid/ciy866

View source ↗

Treatment of Suspected or Confirmed Influenza in Hospitalized Patients

Clinical Scenario

Treatment Approach

Treatment Goals

References