The problem, the consequences, and rapid testing solutions
Each year, influenza (flu) causes serious infection and death around the globe, usually in the winter months (seasonal influenza). Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 290,000 to 650,000 respiratory deaths.1
The Problem
Influenza symptoms are similar to those of other common respiratory infections. Patients presenting with these symptoms are commonly treated empirically, without a formal diagnosis.
The problem in relation to antimicrobial stewardship is twofold. Patients with Influenza-Like Illness (ILI), a medical diagnosis based on symptoms alone, are often treated with antibiotics, even though the most common cause for this set of symptoms is influenza, a viral infection. Antibiotics are not effective against viruses.
Alternatively, these patients are often automatically prescribed with influenza antivirals, which will be unnecessary if influenza is not the cause of infection and are only effective if prescribed within 48 hours of onset of symptoms.

The Consequences
Resistance to influenza anitivirals is emerging. Many strains of influenza have already developed resistance to the older class of flu antivirals, the adamantanes. After five decades of effective use in the prophylaxis and treatment of influenza, global resistance to these drugs has increased significantly in recent years.2
The new class of influenza antivirals, neuraminidase inhibitors, oseltamivir (Tamiflu) and zanamivir (Relenza), are currently suitable for all strains. Resistance to oseltamivir continues to increase worldwide but specific frequencies vary by geographical regions and population densities, with densely populated countries such as the United States, China and South Africa showing significant oseltamivir resistance.3