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Home > Swine Flu
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Swine Flu - Indian Guide Lines
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5. Treatment
The guiding principles are:
- Early implementation of infection control precautions to minimize nosocomical / household spread of disease.
- Prompt treatment to prevent severe illness & death.
- Early identification and follow up of persons at risk.
5.1 Infrastructure / manpower / material support
- Isolation facilities: if dedicated isolation room is not available then patients can be cohorted in a well ventilated isolation ward with beds kept one metre apart.
- Manpower: Dedicated doctors, nurses and paramedical workers.
- Equipment: Portable X Ray machine, ventilators, large oxygen cylinders, pulse oxymeter
- Supplies: Adequate quantities of PPE, disinfectants and medications (Oseltamivir, antibiotics and other medicines)
5.2 Standard Operating Procedures
- Reinforce standard infection control precautions i.e. all those entering the room must use high efficiency masks, gowns, goggles, gloves, cap and shoe cover.
- Restrict number of visitors and provide them with PPE.
- Provide antiviral prophylaxis to health care personnel managing the case and ask them to monitor their own health twice a day.
- Dispose waste properly by placing it in sealed impermeable bags labeled as Bio- Hazard.
5.3 Oseltamivir Medication
- Oseltamivir is the recommended drug both for prophylaxis and treatment.
- Dose for treatment is as follows:
| By Weight |
Recommended Dose |
| For weight <15kg |
30 mg BD for 5 days |
| 15-23kg |
45 mg BD for 5 days |
| 24-<40kg |
60 mg BD for 5 days |
| >40kg |
75 mg BD for 5 days |
| For infants: |
| <3 months |
12 mg BD for 5 days |
| 3-5 months |
20 mg BD for 5 days |
| 6-11 months |
25 mg BD for 5 days
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Note - It is also available as syrup (12mg per ml )
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If needed dose & duration can be modified as per clinical condition.
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Adverse Reactions:
Oseltamivir is generally well tolerated, gastrointestinal side effects (transient nausea, vomiting) may increase with increasing doses, particularly above 300 mg/day. Occasionally it may cause bronchitis, insomnia and vertigo. Less commonly angina, pseudo membranous colitis and peritonsillar abscess have also been reported. There have been rare reports of anaphylaxis and skin rashes. In children, most frequently reported side effect is vomiting. Infrequently, abdominal pain, epistaxis, bronchitis, otitis media, dermatitis and conjunctivitis have also been observed. There is no recommendation for dose reduction in patients with hepatic disease. Though rare reporting of fatal neuro-psychiatiric illness in children and adolescents have been linked to oseltamivir, there is no scientific evidence for a causal relationship.
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