Diagnosis and treatment of seasonal influenza
Journal
Journal of Internal Medicine of Taiwan
Journal Volume
31
Journal Issue
1
Pages
11-17
Date Issued
2020
Author(s)
Abstract
Influenza has a broad spectrum of clinical manifestations that range from asymptomatic infection, to febrile respiratory illness with systemic signs and symptoms, and even to severe pulmonary or extrapulmonary complications. Notably, immunocompromised patients may also present without typical findings of influenza. The management of a patient with suspected influenza should be based on clinical judgement and local epidemiological factors, and should not be directed by laboratory results alone. Current guidelines provide recommendations for proper selection of diagnostic modalities and antiviral agents based on the risk assessment of complications, disease severity, and the influenza activity in the community. Available influenza tests include antigen detection, nucleic acid amplification tests, serologic testing and viral culture. Of these, nucleic acid amplification tests are most recommended to improve detection of influenza virus infection. While uncomplicated influenza is usually self-limited among patients without risk factors of complications, antiviral therapy should be prescribed immediately to patients at high risk of complicated influenza, those with danger signs or severe infection. Approved antiviral agents include neuraminidase inhibitors (oral oseltamivir, inhaled zanamivir, and intravenous peramivir) and cap-dependent endonuclease inhibitor (oral baloxavir). Selection of these antiviral agents and adjustment of the dosage and treatment duration have to be tailored according to the host factors and disease severity. In this article, we summarize major recommendations put forward by recent guidelines for the diagnosis and treatment of influenza, including use of various diagnostic tools and antiviral agents. We aim to facilitate clinicians in making more timely and appropriate diagnosis in order to avoid unnecessary antibiotics use, and to reduce risk of post-influenza complications and disease transmission. ? 2020 Society of Internal Medicine of Taiwan. All rights reserved.
SDGs
Other Subjects
antibiotic agent; antivirus agent; antibiotic therapy; antiviral therapy; Article; clinician; diagnostic test; human; inappropriate prescribing; infection complication; practice guideline; risk reduction; seasonal influenza; virus transmission
Publisher
Society of Internal Medicine of Taiwan
Type
journal article