Infectious Diseases I
ii.
High levels of resistance to the adamantanes (amantadine and rimantadine) have persisted
among circulating influenza A viruses. The adamantanes are not effective against influenza B
viruses; therefore, they are not viable options for the management of contemporary influenza.
Agent
Drug Class;
Influenza
Activity
Bioavailability
Half-life
(hr)
Treatment
Dosage
Adverse
Effects
Comments
Oseltamivir
phosphate
Neuraminidase
inhibitor;
A and B
Orally or
OG/NG tube:
> 75%
6–10
75 mg twice a
day for 5 daysa;
up to 150 mg
twice a day
has been used
in patients
with severe
influenza but is
not associated
with improved
outcomes
and thus is
not currently
recommended
by the CDC
Nausea,
vomiting,
delirium
Dosage
adjustment
for renal
impairment may
be necessary;
patients
requiring
continuous
renal
replacement
therapy should
receive normal
dosing
Peramivir
Neuraminidase
inhibitor;
A and B;
limited clinical
trial experience
for Influenza B
strains
IV: 100%
600 mg once for
15 minutes
Diarrhea,
hypersensitiv-
ity reactions,
delirium
Dosage
adjustment
recommended
in patients
with creatinine
clearance
below 50 mL/
min; should be
administered
after dialysis
in patients
receiving
hemodialysis