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Medical Treatment

Treating symptoms is the cornerstone of managing the flu in children. Home-care methods most recommended include rest, drinking adequate amounts of fluids, control of fever and body aches with nonprescription medication, and maintaining comfortable breathing by means of humidified air in the child's sleeping area.

Medications

Four influenza antiviral drugs are currently licensed in the United States. If given within the first 48 hours, antiviral agents decrease the severity and duration of symptoms, but their ability to prevent complications of influenza A has not been established. The primary drawback of these types of medications is that resistant viruses can slow recovery.

• M2 inhibitors include the drugs amantadine (Symmetrel and Symadine) and rimantadine (Flumadine). Either can be used in the prevention and treatment of influenza type A. Antiviral agents are not effective against influenza B and are not approved for use in children younger than 1 year of age. Rimantadine has not been approved for treatment of children younger than 13 years of age. Amantadine and rimantadine are not recommended by the Centers for Disease Control and Prevention (CDC) for the 2009-2010 influenza season. Laboratory testing by the CDC on the predominant strain of influenza (H1N1) currently circulating in the United States shows that it is resistant to amantadine and rimantadine.



• Neuraminidase inhibitors (NAIs) are FDA approved for uncomplicated influenza when the symptoms have been present for fewer than 48 hours. The main advantages of the NAIs are their activity against both influenza A and B. Zanamivir (Relenza) is approved for treatment in children older than 7 years of age, but it is not approved for prevention. The drug is available as topical powder administered by a breath-activated inhalation device. Oseltamivir (Tamiflu) is licensed for children older than 1 year of age and has been recommended by the CDC for children under 1 year of age during the H1N1 outbreak. It is available as a tablet and suspension and is usually taken for five days.



• Side effects: The use of amantadine has been associated with central nervous system side effects, including headache, insomnia, confusion, and failure to concentrate. In addition, the risk of seizure activity during therapy with amantadine in people with known seizure disorders is increased, even if they use medications to counteract that side effect. These side effects go away when a person stops taking the drug. Gastrointestinal side effects, such as nausea and loss of appetite, occur in 3% of people taking them.



• Currently, no antiviral agents exist for use against influenza C infections.
  
  
• The broad-spectrum antiviral agent ribavirin (Rebetol, Virazole Aerosol), given in aerosol form like nebulization, has benefited adults with influenza A and B infections. Ribavirin is not approved for treatment of influenza in children.