Influenza estacional en adultos y niños—Diagnóstico, tratamiento, quimioprofilaxis y control de brotes institucionales: Guías de práctica clínica de la Sociedad de Enfermedades Infecciosas de Estados Unidos de América

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Abstract

Un Grupo de Expertos de la Sociedad de Enfermedades Infecciosas de los Estados Unidos de América elaboró las guias para el tratamiento de personas infectadas por el virus de la influenza. Estas guias basadas en datos y pruebas cientificas comprenden el diagnóstico, el tratamiento y la quimioprofilaxis con medicamentos antivirales, además de temas relacionados con el control de brotes de influenza estacional (interpandémicas) en ámbitos institucionales. Están destinadas a los médicos de todas las especialidades a cargo de la atención directa de pacientes porque los médicos generales que atienden una gran variedad de casos son los que se enfrentan con la influenza, frecuente en el ámbito comunitario durante la temporada de influenza.

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Update on avian influenza A (H5N1) virus infection in humans.

Timothy Uyeki, J. S. Malik Peiris, Santoso Soeroso … (2008)

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Anne Moscona (2005)

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Clinical signs and symptoms predicting influenza infection.

Arnold Monto, Stefan Gravenstein, Michael Elliott … (2000)

New antiviral drugs are available for the treatment of influenza type A and type B infections. In clinical practice, antiviral use has rarely been guided by antecedent laboratory diagnosis. Defined clinical predictors of an influenza infection can help guide timely therapy and avoid unnecessary antibiotic use. To examine which clinical signs and symptoms are most predictive of influenza infection in patients with influenza-like illness using a large data set derived from clinical trials of zanamivir. This analysis is a retrospective, pooled analysis of baseline signs and symptoms from phase 2 and 3 clinical trial participants. It was conducted in mainly unvaccinated (mean age, 35 years) adults and adolescents who had influenza-like illness, defined as having fever or feverishness plus at least 2 of the following influenza-like symptoms: headache, myalgia, cough, or sore throat who underwent laboratory testing for influenza. Clinical signs and symptoms were evaluated in statistical models to identify those best predicting laboratory confirmation of influenza. Of 3744 subjects enrolled with baseline influenza-like symptoms, and included in this analysis, 2470 (66%) were confirmed to have influenza. Individuals with influenza were more likely to have cough (93% vs 80%), fever (68% vs 40%), cough and fever together (64% vs 33%), and/or nasal congestion (91% vs 81%) than those without influenza. The best multivariate predictors of influenza infections were cough and fever with a positive predictive value of 79% (P<. 001). The positive predictive value rose with the increase in the temperature at the time of recruitment. When influenza is circulating within the community, patients with an influenza-like illness who have both cough and fever within 48 hours of symptom onset are likely to have influenza and the administration of influenza antiviral therapy may be appropriate to consider. Arch Intern Med. 2000;160:3243-3247.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin. Infect. Dis

Journal ID (hwp): cid

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: The University of Chicago Press

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date (Print): 15 April 2009

Publication date (Electronic): 15 April 2009

Publication date PMC-release: 15 April 2009

Volume: 48

Issue: 8

Pages: 1003-1034

Affiliations

[1 ] Centros para el Control y la Prevención de Enfermedades , Atlanta, Georgia

[2 ] Rady Children's Hospital

[3 ] Universidad de California en San Diego, Facultad de Medicina , San Diego

[4 ] Universidad de Washington, Facultad de Medicina

[5 ] PATH , Seattle, Washington

[6 ] Summa Health System , Akron, Ohio

[7 ] Alpert Medical School, Brown University

[8 ] Quality Partners of Rhode Island , Providence, Rhode Island

[9 ] Universidad de Virginia, Facultad de Medicina , Charlottesville, Virginia

[10 ] Facultad de Medicina, Universidad de Utah , Salt Lake City, Utah

[11 ] Lenox Hill Hospital

[12 ] Facultad de Medicina, Universidad de New York , New York

[13 ] Universidad de Pittsburgh Facultad de Medicina , Pittsburgh, Pennsylvania

[14 ] Universidad de Toronto , Ontario, Canada

Author notes

Reimpresiones o correspondencia: Dr. Scott A. Harper, 125 Worth St., Box 22- A, New York, NY 10013 ( svh9@ 123456cdc.gov ).

Es importante advertir que, en las guias, no es posible tener en cuenta siempre las variaciones individuales que se presenten entre pacientes. Las guias no intentan reemplazar el criterio del médico respecto de pacientes en particular o cuadros clinicos especiales. La Sociedad de Enfermedades Infecciosas de Estados Unidos de América considera que la adhesión a estas guias es voluntaria y que la determinación final sobre su aplicación corresponde al médico conforme a la situación individual de cada paciente. Los hallazgos y las conclusiones de este informe pertenecen a los autores y no representan, necesariamente,la postura oficial de los Centros para el Control y Prevención de Enfermedades.

Article

DOI: 10.1086/604670

PMC ID: 7107965

PubMed ID: 19281331

SO-VID: f10c3061-f81c-41e5-bd81-fc7f0c46d8ab

License:

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

Influenza estacional en adultos y niños—Diagnóstico, tratamiento, quimioprofilaxis y control de brotes institucionales: Guías de práctica clínica de la Sociedad de Enfermedades Infecciosas de Estados Unidos de América

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