Influenza chemoprophylaxis* regimens for children and close contacts in the outpatient setting^[1-3]

Type of prophylaxis	When to initiate	Available agents^¶	Duration
Postexposure prophylaxis	As soon as possible within 48 hours of exposure	Oral oseltamivir Inhaled zanamivir	Until 7 days after most recent exposure
Postexposure prophylaxis	As soon as possible within 48 hours of exposure	Oral baloxavir	Single dose
Pre-exposure prophylaxis awaiting response to influenza vaccine	Onset of influenza activity in the community^Δ	Oral oseltamivir Inhaled zanamivir	14 days after receipt of influenza vaccine
Other indications for pre-exposure prophylaxis	Onset of influenza activity in the community^Δ	Oral oseltamivir Inhaled zanamivir	Duration of influenza activity in the community

* Chemoprophylaxis is not routinely recommended. Chemoprophylaxis of select children ≥3 months of age who are at very high risk of severe or complicated influenza (eg, those who are severely immunocompromised) or their close contacts is an alternative to early initiation of antiviral therapy. Refer to related UpToDate content for dosing information.

¶ Laninamivir is another inhaled neuraminidase inhibitor that is available for prophylaxis in Japan.

Δ Information about influenza activity at the national, regional, and state level is available from the United States Centers for Disease Control and Prevention (FluView interactive) and the World Health Organization (FluNet). Local hospital or clinic laboratories may also collect information about influenza activity in a specific geographic area.

References:

Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clin Infect Dis 2019; 68:e1.
Fiore AE, Fry A, Shay D, et al. Antiviral agents for the treatment and chemoprophylaxis of influenza – Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011; 60:1.
Centers for Disease Control and Prevention. Influenza antiviral medications: Summary for clinicians. Available at: https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm (Accessed on September 8, 2022).

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Influenza chemoprophylaxis* regimens for children and close contacts in the outpatient setting[1-3]

Influenza chemoprophylaxis* regimens for children and close contacts in the outpatient setting^[1-3]