Antibacterial therapy
Co-infections with bacterial pathogens occur often with RVI. Co-infection with Staphylococcus aureus is common with influenza pneumonia and can be especially virulent [10]. The recent 2019 ATS/IDSA clinical practice guidelines recommend standard antibacterial therapy to be initially prescribed for adults with community-acquired pneumonia who test positive for influenza [10]. The guidelines provide details on when to consider empiric therapy for methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa and provide guidance for de-escalation of antibacterial therapy in patients with confirmed influenza [10]. Clinicians should be aware of the reports of invasive pulmonary aspergillosis in severely ill influenza patients especially those with underlying conditions or receiving corticosteroids, although up to 30% of patients with influenza-associated aspergillosis had been previously healthy [41].