Dosing recommendations for oseltamivir for the treatment or prophylaxis of influenza in infants younger than 1 year

	Treatment*	Prophylaxis^¶
Term infants with known body weight
<3 months^Δ	3 mg/kg per dose orally twice daily for 5 days	Not recommended except in critical situations^◊
3 through 8 months	3 mg/kg per dose orally twice daily for 5 days	3 mg/kg orally once daily
9 through 11 months	3.5 mg/kg per dose orally twice daily for 5 days	3.5 mg/kg orally once daily
Term infants whose body weight is not known
Age 0 through 3 months^Δ	12 mg orally twice daily for 5 days	Not recommended except in critical situations^◊
Age 4 through 5 months	17 mg orally twice daily for 5 days	17 mg orally once daily
Age 6 through 11 months	24 mg orally twice daily for 5 days	24 mg orally once daily
Preterm infants
PMA <28 weeks^Δ	Consultation with a specialist in pediatric infectious diseases is recommended	Not recommended except in critical situations^◊
PMA 28 through 37 weeks, 6 days	1 mg/kg per dose orally twice daily for 5 days
PMA 38 through 40 weeks, 0 days	1.5 mg/kg per dose orally twice daily for 5 days
PMA >40 weeks through 8 months chronologic age	3 mg/kg per dose orally twice daily for 5 days
Chronologic age 9 months through 11 months	3.5 mg/kg per dose orally twice daily for 5 days	3.5 mg/kg per dose orally once daily

This table is meant for use with UpToDate content on the prevention and treatment of influenza in children. Oseltamivir is supplied as an oral suspension (6 mg/mL). Providers and pharmacists must take care to provide a dosing device that matches the units of measure on the directions provided to the caregiver and that can accurately deliver the dose prescribed. Dose adjustment is necessary for patients with decreased or decreasing glomerular filtration rate. Refer to UpToDate content for additional details (eg, indications for treatment or prophylaxis).

PMA: postmenstrual age (gestational age plus chronologic age).

* The usual duration of treatment is 5 days. Hospitalized patients with severe illness and immunocompromised patients may require an extended course of therapy.

¶ The duration of prophylaxis varies with the clinical circumstances.

Δ Although not part of the US Food and Drug Administration-approved indications, use of oral oseltamivir for treatment of influenza in infants less than 14 days old, and for chemoprophylaxis in infants 3 months to 1 year, is recommended by the American Academy of Pediatrics and Centers for Disease Control and Prevention.^[1,2]

◊ Consultation with a specialist in pediatric infectious diseases is recommended.

References:

Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2022-2023. Pediatrics 2022; :e2022059274.
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 September 6, 2022).

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Dosing recommendations for oseltamivir for the treatment or prophylaxis of influenza in infants younger than 1 year