Treatment strategies for influenza disease at the Seattle Cancer Care Alliance
| . | First-line treatment . | Second-line treatment . | Research protocols . |
|---|---|---|---|
| Asymptomatic shedding | Consider neuraminidase inhibitors (monotherapy) | No treatment, isolation, observe for development of symptoms | None |
| Upper respiratory infection | Oral/inhaled neuraminidase inhibitors (monotherapy)—dependent on circulating strain susceptibility | Oral/inhaled neuraminidase inhibitors (monotherapy)—alternative agent | Triple combination therapy vs monotherapy (phase 2) |
| Lower respiratory tract disease (no respiratory failure) | Oseltamivir (high dose) Consider IV peramivir. Consider combination therapy | Consider IVIG | IV zanamivir (phase 2) |
| Lower respiratory tract disease (respiratory failure, mechanical ventilation) | IV peramivir/zanamivir combination therapy | IVIG | None |
| . | First-line treatment . | Second-line treatment . | Research protocols . |
|---|---|---|---|
| Asymptomatic shedding | Consider neuraminidase inhibitors (monotherapy) | No treatment, isolation, observe for development of symptoms | None |
| Upper respiratory infection | Oral/inhaled neuraminidase inhibitors (monotherapy)—dependent on circulating strain susceptibility | Oral/inhaled neuraminidase inhibitors (monotherapy)—alternative agent | Triple combination therapy vs monotherapy (phase 2) |
| Lower respiratory tract disease (no respiratory failure) | Oseltamivir (high dose) Consider IV peramivir. Consider combination therapy | Consider IVIG | IV zanamivir (phase 2) |
| Lower respiratory tract disease (respiratory failure, mechanical ventilation) | IV peramivir/zanamivir combination therapy | IVIG | None |
Institutions comprising the Seattle Cancer Care Alliance are Fred Hutchinson Cancer Research Center, University of Washington, and Seattle Children's Hospital.
IVIG indicates intravenous immune globulin.