Antiviral treatment for influenza works best when started early. In patients admitted to hospital with suspected influenza, and in outpatients at high risk of complications — older adults, pregnant women, people with chronic heart, lung, kidney or metabolic disease, and the immunocompromised — established guidance supports starting oseltamivir on clinical suspicion during the season.
A negative rapid antigen test does not exclude influenza. Where a molecular test is available, send it, but do not hold treatment for the result in a patient who is unwell or at high risk.
- Start oseltamivir promptly in admitted patients with suspected influenza during the season.
- Treat high-risk outpatients on clinical suspicion rather than waiting for a result.
- Do not rely on a negative rapid antigen test to rule influenza out.
- Adjust the oseltamivir dose for reduced kidney function.
Why it matters
The benefit of antivirals falls with every day of delay.
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