The recommendations for TREATMENT are:
Rec 01: In patients with confirmed or strongly suspected H5N1 infection, clinicians should administer oseltamivir treatment as soon as possible (strong recommendation, very low quality evidence).
Rec 02: In patients with confirmed or strongly suspected infection with avian influenza A (H5N1) virus, clinicians might administer zanamivir (weak recommendation, very low quality evidence).
Rec 03: If neuraminidase inhibitors are available, clinicians should not administer amantadine alone as a first-line treatment to patients with confirmed or strongly suspected human infection with avian influenza H5N1 (strong recommendation, very low quality evidence).
Rec 04: If neuraminidase inhibitors are not available and especially if the virus is known or likely to be susceptible, clinicians might administer amantadine as a first-line treatment to patients with confirmed or strongly suspected infection with avian influenza A (H5N1) virus (weak recommendation, very low quality evidence).
Rec 05: If neuraminidase inhibitors are available, clinicians should not administer rimantadine alone as a first-line treatment to patients with confirmed or strongly suspected infection with avian influenza A (H5N1) virus (strong recommendation, very low quality evidence).
Rec 06: If neuraminidase inhibitors are not available and especially if the virus is known or likely to be susceptible, clinicians might administer rimantadine as a first-line treatment to patients with confirmed or strongly suspected infection with avian influenza A (H5N1) virus (weak recommendation, very low quality evidence).
Rec 07: If neuraminidase inhibitors are available and especially if the virus is known or likely to be susceptible, clinicians might administer a combination of neuraminidase inhibitor and M2 inhibitor to patients with confirmed or strongly suspected infection with avian influenza A (H5N1) virus (weak recommendation, very low quality evidence). This should only be done in the context of prospective data collection.
Tamiflu dosage:
There is currently no empirical evidence to suggest the use of a loading dose or higher doses of oseltamivir in patients with severe disease but increased doses and duration of treatment have been suggested as a strategy to reduce the risk for development of drug resistance.
However, Consistent animal data from three studies in mice indicate that high]dose oseltamivir treatment increased survival in this animal model.