Influenza

Patient Population:
Pediatric
Condition Major Pathogens  First Choice Therapy Alternative Therapy Comments

Influenza 

See detailed Influenza Guidelines including treatment indications 

Influenza Virus

Oseltamivir according to body weight: 

Preterm infants:  

<38 weeks corrected gestational age: 1 mg/kg/dose enterally bid 

38-40 weeks corrected gestational age: 1.5 mg/kg/dose enterally bid 

>40 weeks corrected gestational age: same as term infant dosing 

Contact Pediatric ID/ASP for infants with corrected gestational age < 28 weeks 


Term infants 0-8 months

3 mg/kg/dose enterally bid 

Infants 9-11 months

3.5 mg/kg/dose enterally bid 


Children >=12 months

<=15kg: 30 mg/dose enterally bid 

>15-23kg: 45 mg/dose enterally bid 

>23-40kg: 60 mg/dose enterally bid 

>40kg: 75 mg/dose enterally bid 


Duration: 5 days for most patients* 


*For patients with critical illness or significant immunocompromise, longer courses may be considered based on severity of illness. Please consult ID for assistance in these cases. 

Zanamivir can be used for children age >= 7 years old for treatment or >= 5 years old for prophylaxis - consider in patients unable to tolerate PO but able to use dry powder inhaler: 

Zanamivir
10 mg/dose (2 inhalations) INH bid
 

Duration:  Treatment, most patients: 5 days* 

Prophylaxis: 7 days 

Consult Pediatric ID for use of Peramivir in critically ill patients unable to receive or absorb enteral medications 

Consult Pediatric ID for use of Baloxivir in patients early in course but with especially high risk for influenza-related complications  

Oseltamivir Dosing for Prophylaxis (most effective if initiated within 48-72 hours of exposure:  

Age < 3 months: not recommended 


Infants 3-8 months

3 mg/kg/dose enterally daily 


Infants 9-11 months

3.5 mg/kg/dose enterally daily 


Children >= 12 months:  

<=15kg: 30 mg/dose enterally daily 

>15-23kg: 45 mg/dose enterally daily 

>23-40kg: 60 mg/dose enterally daily 

>40kg: 75 mg/dose enterally daily 


Duration: 7 days 

References: 

American Academy of Pediatrics, Committee on Infectious Diseases. Recommendations for prevention and control of influenza, 2020-2021. Pediatrics 2020;146:e2020024588. 

CDC Influenza Antiviral Medications: Summary for Clinicians