Influenza in children, how to use anti-influenza drugs?

Author: Chen Yue, First Hospital of Jilin University

Reviewer: Zhao Jie, Chairman of the Chinese Medical Association Clinical Pharmacy Branch, The First Affiliated Hospital of Zhengzhou University

Chief Pharmacist Professor

Compared with the common cold, influenza (referred to as "flu") occurs less frequently in our lives. The peak influenza season in my country lasts from November of the current year to March of the following year. The main symptoms of influenza are systemic symptoms, including fever, cough, headache, muscle aches, etc. Its symptoms are similar to those of the common cold, but more severe overall. Oseltamivir is a clinically recommended first-line oral drug against influenza viruses. How should children take oseltamivir correctly, and what are the precautions? How to use medication to relieve other symptoms of influenza?

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1. How should children take oseltamivir correctly?

Oseltamivir is currently the first choice for treating influenza in children. It is a neuraminidase inhibitor that is effective against both influenza A and B. It can inhibit the replication of influenza viruses in the body, shorten the course of influenza, reduce mortality, and has good safety. Oseltamivir has two dosage forms, namely granules (15 mg) and capsules (75 mg). Currently, the State Food and Drug Administration has approved oseltamivir for the treatment of influenza A and B in children aged 1 year and above, and for the treatment and prevention of influenza A and B in people aged 13 years and above.

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Note: Once influenza is confirmed or suspected, it is recommended that children with influenza be given antiviral drugs as soon as possible within 48 hours, which can effectively reduce the mortality rate of hospitalized children and shorten the length of hospitalization.

2. What are the precautions for children taking oseltamivir?

1. Children are recommended to take granules so that the dosage can be accurately controlled.

2. Taking the drug with food can reduce the drug's irritation to the stomach.

3. When giving this medicine to children, parents should closely observe whether the children have any adverse reactions after taking the medicine.

4. If the condition is serious, or the child is hospitalized, or there are high-risk factors for complications, it can still be considered for use after more than 48 hours.

5. If you forget to take a dose at any time, you should make up for it as soon as possible. However, if you miss a dose and it is almost time for the next scheduled dose, do not make up for it, and be sure not to take two doses together.

6. The course of treatment for influenza with oseltamivir is 5 days, and the course of treatment for influenza prevention is 7 to 14 days. Even if the child's condition improves during the course, it is recommended to complete the entire course of treatment as directed by the doctor.

7. The most common adverse reaction of this drug is gastrointestinal reaction, which is generally mild and can be relieved by itself, such as nausea, vomiting, etc. However, there are also reports of serious adverse reactions after the drug is put on the market, such as severe allergies, hallucinations, convulsions, etc. Therefore, when giving this drug to children, parents should closely observe the reaction of their children after taking the drug, and should not take it lightly. Once a serious adverse reaction occurs, the drug should be stopped immediately and medical treatment should be sought.

3. Which symptoms require immediate hospital visit?

1. Continuous high fever for more than 3 days, accompanied by severe cough, coughing up purulent sputum, bloody sputum, or chest pain.

2. Rapid breathing rate and difficulty breathing.

3. Changes in mental state, such as slow reaction, drowsiness, agitation, convulsions, etc.

4. Severe vomiting, diarrhea, and signs of dehydration.

5. Combined with pneumonia or significant worsening of the original underlying disease.

Note: Oseltamivir is not a miracle drug. If your symptoms do not improve after taking oseltamivir prescribed by your doctor, you should go to the hospital as soon as possible.

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IV. Recommended medications for relieving other symptoms of influenza

1. For symptoms such as fever and body aches, if the fever reaches above 38.5℃, or the baby's mental state is poor, antipyretics such as acetaminophen and ibuprofen can be used.

2. To relieve symptoms such as nasal congestion, runny nose and sneezing, parents can use physiological seawater to clean the child's nasal cavity; if medication is used to relieve symptoms, decongestants can be used, such as 0.05% xylometazoline hydrochloride nasal drops (not recommended for children under 3 years old), etc., but continuous use should not exceed 7 days; parents can also use antihistamines, such as cetirizine, loratadine syrup, etc., which help reduce nasal secretions.

3. It is generally not recommended to use centrally acting antitussive drugs to relieve cough symptoms. If the child's dry cough affects rest and sleep, dextromethorphan solution may be used to relieve the symptoms as appropriate. Parents should try to give the child more water, and maintain appropriate temperature and humidity to help the child relieve symptoms.

4. To relieve the symptoms of excessive sputum, you can choose drugs such as ambroxol and acetylcysteine ​​and give them according to the dosage in the instructions. Note that special dosage forms of effervescent tablets need to be dissolved in warm water before taking, and cannot be swallowed directly to avoid suffocation of children.