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<sup>17</sup> Dx based on clinical, rapid dx testing; negative testing does not r/o influenza. Antiviral decision should not wait for lab confirmation. Tx based on clinical suspicion, start ASAP, w/in 48hr of sx onset.<br><br>
<sup>18</sup> Renal. Oseltamivir tx dose in adults: if CrCl 31-60 mL/min: 30 mg PO bid x 5 days; if CrCl 11-30: 30 mg PO daily x 5 days. ESRD (hemodialysis): 30 mg PO after every HD cycle, tx x 5 days; (CAPD): 30 mg x1 after dialysis exchange. Zanamivir: limited data available on renal impairment. If mild-to-moderate/severe renal impairment: mfr recommends no dose adjustment for inhaled zanamivir 5-day tx course. Peramivir: if CrCl 30-49 mL/min: 200 mg IV x 1; if CrCl 10-29 mL/min: 100 mg IV x 1; ESRD: dose (based on CrCl) after dialysis.
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<sup>19</sup> Zanamivir not recommended if underlying respiratory dz (asthma, COPD, etc) or allergic to milk protein.
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<sup>20</sup> Peramivir not approved for influenza prophylaxis.
<sup>18</sup> Renal. Oseltamivir tx dose in adults: if CrCl 31-60 mL/min: 30 mg PO bid x 5 days; if CrCl 11-30: 30 mg PO daily x 5 days. ESRD (hemodialysis): 30 mg PO after every HD cycle, tx x 5 days; (CAPD): 30 mg x1 after dialysis exchange. Zanamivir: limited data available on renal impairment. If mild-to-moderate/severe renal impairment: mfr recommends no dose adjustment for inhaled zanamivir 5-day tx course. Peramivir: if CrCl 30-49 mL/min: 200 mg IV x 1; if CrCl 10-29 mL/min: 100 mg IV x 1; ESRD: dose (based on CrCl) after dialysis.
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<sup>19</sup> Zanamivir not recommended if underlying respiratory dz (asthma, COPD, etc) or allergic to milk protein.
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<sup>20</sup> Peramivir not approved for influenza prophylaxis.
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