The CDC has issued recommendations for the use of anti-viral medications in patients with influenza this year, due to the high resistance of Influenza A (H1N1) to oseltamivir. Of the few Influenza A (H1N1) strains tested this year, 98% were resistant to oseltamivir (but all were susceptible to zanamivir, amantadine, and rimantadine) (CDC site). They recommend avoiding oseltamivir in patients with Influenza A (unless local surveillance suggests the dominant Influenza A strain is H3N2, and not H1N1). Oseltamivir can still be used for Influenza A (H3N2) or Influenza B. Amantadine and rimantadine have no activity against Influenza B, and are generally ineffective against Influenza A (H3N2). In summary, Influenza A (H1N1) can be treated with zanamivir, amantadine or rimantadine; Influenza A (H3N2) can be treated with zanamivir or oseltamivir; Influenza B can be treated with zanamivir or oseltamivir.
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