In this section : Infectious Diseases
Paediatric Antimicrobial Guidance
Treatment of Malaria
Gentamicin Prescribing (Paediatrics)
Influenza A
HIV Testing Guidelines
Clostridiodes difficile Infection
Blood Culture
OPAT SBAR (Complex Infections)
Staphylococcus aureus Bacteraemia (SAB)
Neutropenic Sepsis
Antibiotics and the Kidney
Acute Diarrhoea
Suspected Meningitis
Suspected Sepsis
Gentamicin Dosing
Urinary Tract Infection
Vancomycin Dosing
Cellulitis
Post Splenectomy Sepsis
Home | Articles | Infectious Diseases |
Influenza A
Last updated 9th January 2023
NHSD&G is experiencing an increase in Influenza cases. It appears that some patients are not being considered for influenza NAI therapy as per recent CMO guidelines (see ‘Links’ below)
Risk Factors for Complicated Influenza
These include:
- neurological, hepatic, renal, pulmonary and chronic cardiac disease
- diabetes mellitus
- severe immunosuppression
- age over 65 years
- pregnancy (including up to 2 weeks post-partum)
- children under 6 months of age
- morbid obesity (BMI ≥40)
- for full details refer to ‘Immunisation against infectious disease’,(known as the Green Book)
Severe Immunosuppression
Degrees of immunosuppression are difficult to quantify and individual variation exists, therefore this list is not comprehensive.
Examples of severe immunosuppression include:
- Severe primary immunodeficiency
- Current or recent (within 6 months) chemotherapy or radiotherapy for malignancy.
- Solid organ transplant recipients on immunosuppressive therapy
- Bone marrow transplant recipients currently receiving immunosuppressive treatment, or within 12 months of receiving immunosuppression
- Patients with current graft-versus-host disease
- patients currently receiving high dose systemic corticosteroids (equivalent to ≥40 mg prednisolone per day for >1 week in an adult, or ≥ 2mg/kg/day for ≥1 week in a child), and for at least 3 months after treatment has stopped.
- HIV infected patients with severe immunosuppression (CD4<200/microL or <15% of total lymphocytes in an adult or child over 5; CD4< 500/microL or <15% of total lymphocytes in a child aged 1 to 5; expert clinical opinion in a child aged under 1)
- Patients currently or recently (within 6 months) on other types of highly immunosuppressive therapy or where the patient’s specialist regards them as severely immunosuppressed.
Links
- Guidance on the use of antiviral agents for the treatment and prophylaxis of seasonal influenza – gov.uk
- CMO SGHD/CMO(2022)39 Seasonal Influenza: Use of Antivirals 2022-23 [pdf]
Content by Dr Martin Connor and Dr Ken Donaldson