camoman1234 Posted February 8, 2018 Share Posted February 8, 2018 3 hours ago, lkth487 said: That's easy - I don't use it. I've used it only a handful of times in super critically ill peds patients but overall, it's such a stupid drug. Like for intubated kids, people talk about IV version, but there's no benefit: https://www.ncbi.nlm.nih.gov/m/pubmed/25115871/ For the oral version, the only times I've used it was in confirmed cases of pediatric influenza where the sx began less than 72 hours ago AND the child was high risk (not just by age as the CDC defines it but due to other factors such as, premature lungs, a genetic immunodeficiency or a baby with HIV for example). I personally don't find the data compelling enough to justify the use of the medication vs the side effects. I agree and have the same thoughts/feelings. Thanks for the reply. Link to comment Share on other sites More sharing options...
HMtoPA Posted February 8, 2018 Share Posted February 8, 2018 I don't understand all the anti-Tamiflu hate. From what I've read, it shortens the duration and severity of symptoms measurably, and reduces the risk of complications. It's available as a generic, covered by insurance, and not in short supply this year, AFAIK. The main side effects (N/V/HA) are the same potential side effects of any drug, or of placebo for that matter. Am I missing something? That's a honest, non-rheotrical, non-snarky question. My practice: if clinically-evident flu for <48 hours, I discuss risks vs. benefits and let the patient decide. I discuss flu as a generally benign and self-limited illness treated primarily with supportive therapy, but of course there are deaths every year and this year it seems to be especially unpredictable (and all over the news). I find that most parents who are concerned enough to bring their kid into the office so quickly prefer to try the Tamiflu, and I don't begrudge them one bit. With "high-risk" patients I do try to sell the Tamiflu more. RE: flu swabs, I usually only get them because chart review, or to convince a patient that they don't have flu when I suspect a cold. To me, abrupt-onset fever and body aches with URI symptoms in the setting of an epidemic IS flu, and I don't generally trust a negative test. Just last week I had three siblings with identical HPI & PE, and only 2 of 3 came back with a positive swab. There's absolutely no way that 3rd kid din't have flu, whether there was an error in collection or processing, or just buil-in margin or error, I don't know - but the test was definitely wrong. Link to comment Share on other sites More sharing options...
Guest ral Posted February 9, 2018 Share Posted February 9, 2018 HMtoPA: I'll join you at the minority table. I discuss it, explain the risk vs benefit, and then ask the patient what they would like to do. I don't see the big deal here. I have a study saved somewhere that I might share if I can remember where I put it. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 9, 2018 Share Posted February 9, 2018 Add me to the list of folks at the minority table of people handing it out like campaign buttons. Had a patient parent call today about abd pain after taking it. Fine. Stop the med, see your PCP since we don’t see you back, and let them exclude other source for belly pain. Is this the table where we get two desserts if we let the big people talk amongst themselves? Link to comment Share on other sites More sharing options...
lkth487 Posted February 9, 2018 Share Posted February 9, 2018 and let them exclude other source for belly pain. Thanks for that. Cause you know teenagers with vague abdominal pains are my fav. :p Link to comment Share on other sites More sharing options...
Guest ral Posted February 9, 2018 Share Posted February 9, 2018 Okay, found it. This could be a whole new thread on its own but, I considered this to be a decent read. Those of you who have time, could read the entire article. Those who want to get to the beef, scroll to about two thirds of the way down the page, and start at "Antiviral Therapy". Each person may take away a different opinion, and it matters not to me which conclusion you draw. From my homeland of Canada, I bring you: http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)62800-7/fulltext Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 13, 2018 Share Posted February 13, 2018 I gotta say. I’m getting darn tired of all these ILI patients and not a darn one gets vaccinated. Just saw a kid on round two. Still no flu shot. WTH!? Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
sas5814 Posted February 13, 2018 Share Posted February 13, 2018 My wife's sister is a rabid anti-vaxxer. She asked her sister "so you vaccinate your dog but not your children?" Link to comment Share on other sites More sharing options...
lkth487 Posted February 13, 2018 Share Posted February 13, 2018 I have PTSD from that stuff. Link to comment Share on other sites More sharing options...
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