Table 1.
Viral infection | Antiviral agents | Drug class/Mechanism of action | Dosage and duration of treatment regimen | Concerns for drug resistance |
---|---|---|---|---|
Influenza virus | Oseltamivir | NAI | 75 mg orally twice daily Recommended duration is 5 days Longer duration (10 days) for immunocompromised individuals [8] Two inhalations (10 mg) twice daily for 5 days [8] |
Influenza A(H1N1) virus strains H275Y substitution leads to resistance [10,11] |
Zanamavir | NAI | Intravenous zanamivir available through compassionate use program Single dose of 600 mg administered intravenously [8] |
Influenza A (H1N1) with both an H275Y and an E119D or E119G NA substitution lead to resistance to zanamivir [12,13]. | |
Peramivir | NAI | Longer duration of 5 days in high-risk patients [9]. | Influenza A(H1N1) virus with H275Y substitution leads to resistance to peramivir [14] | |
Amantadine | M2 inhibitor | 200 mg given once daily or 100 mg given twice daily over 24–48 h after symptoms resolve (duration of therapy is generally 5 days) [8] | Mutations of the pore-lining residues in the ion channel prevents adamantine and rimantadine from entering the channel | |
Rimantadine | M2 inhibitor | 100 mg twice daily for 5–7 days [8] | ||
Respiratory syncytial virus | Ribavirin | Inhibits enzyme dehydrogenase and reduces the cellular deposits of guanidine necessary for viral growth [15] | Aerosolized ribavirin can be administered as 2 g for 2 h every 8 h or as 6 g over 18 h every day for 7–10 d [16] Oral ribavirin – loading dose of 600 mg followed by 200 mg every 8 h on the first day, 400 mg every 8 h the second day, and then escalation to a maximum of 30 mg/kg/day [16] |
None reported |
Parainfluenza virus | None licensed | |||
Human rhinovirus | None licensed | |||
Human Metapneumovirus | None licensed |
NAI: neuraminidase inhibitors