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Flu in Russia will be treated according to new rules: what has changed for patients in 2026
The Russian Ministry of Health has approved an updated standard for the diagnosis and treatment of influenza in adults. The document entered into force last week. The new rules have shortened the average duration of therapy, introduced mandatory laboratory confirmation of diagnosis, and excluded broad-spectrum antibiotics from basic treatment. What examinations are now required by doctors, what medications will be prescribed and what will change for patients — in the Izvestia article.
Why has the duration of flu treatment been shortened?
The new procedure is fixed by the order of the Ministry of Health of the Russian Federation No. 703n "On approval of the standard of medical care for adults with influenza (diagnosis and treatment)". It applies to both outpatient treatment and inpatient care, including specialized departments and intensive care units.
The document regulates not only the list of medicines, but also the volume of medical services, the frequency of examinations, the list of laboratory and instrumental studies, as well as the average duration of treatment. One of the key innovations was the reduction of the average duration of treatment. Previously, the standard provided for up to 15 days, and in severe cases — up to 20 days, now the average is nine days.
However, we are not talking about a hard limit, but about a clinical guideline. The doctor still decides on discharge based on the patient's condition, the dynamics of symptoms and the presence of complications. At the same time, the new standard may affect the length of sick leave, which will more often be closed earlier than it was under the previous rules.
Why were antibiotics excluded from the standard
The most notable change was the exclusion of broad-spectrum antibiotics from the basic treatment of influenza. The new standard contains a list of 25 medicinal names that can be used in the treatment. It includes antiviral drugs, antipyretics based on paracetamol and ibuprofen, cough medicines, including ambroxol and bromhexine, as well as vasoconstrictor nasal drops.
At the same time, a number of items that appeared in the previous standard were excluded from the list, including nootropic drugs and some auxiliary agents that have no proven effectiveness in the treatment of viral infections.
The diagnosis can no longer be made "by eye"
Now the diagnosis of "flu" requires laboratory confirmation. The doctor is obliged to conduct an express test for influenza A and B viruses or send the patient for a PCR examination of a nasopharyngeal smear.
In total, 27 laboratory diagnostic methods are fixed in the standard. In addition to tests for influenza and parainfluenza, it includes studies on respiratory syncytial virus, adenovirus, metapneumovirus, rhinoviruses, bocaviruses and seasonal coronaviruses. A general and biochemical blood test, determination of the level of C-reactive protein, procalcitonin, coagulogram, assessment of the acid-base state and blood gases are also provided.
Instrumental diagnostics has been expanded due to mandatory pulse oximetry, chest X-ray and paranasal sinuses. In severe cases, spinal puncture and bronchoalveolar lavage are allowed.
Which specialists will examine the patients
The list of doctors involved in the examination of patients with a complicated course of the disease has also changed. The new standard focuses on consultations with a pulmonologist, cardiologist, hematologist and obstetrician-gynecologist. In a hospital, patients with severe flu should be examined daily by an anesthesiologist.
An ophthalmologist, an endocrinologist, and an otorhinolaryngologist, who were present in the previous version of the document, were removed from the list of specialists, but therapists and infectious diseases specialists remained involved.
For hospitalized patients, the standard establishes daily examinations by the attending physician, constant medical supervision and repeated consultations to assess the effectiveness of therapy and its possible correction. The list of non-medicinal methods includes oxygen therapy and extracorporeal membrane oxygenation (ECMO), which is used for severe respiratory failure. In addition, it is recommended to follow a gentle diet throughout the entire treatment period.
What will change for patients in practice
For visitors to polyclinics, the new rules mean that the doctor does not have the right to prescribe an antibiotic "for reinsurance" if there are no signs of bacterial complications. If the patient's condition worsens, they will be sent for additional examinations and consultations with specialized specialists.
In 2026, flu testing is carried out free of charge under the compulsory medical insurance policy when contacting a therapist, which helps to quickly distinguish a viral infection from other respiratory diseases and select the correct therapy from the first days of the disease.
It is assumed that the updated standard will reduce the unjustified use of drugs, increase the accuracy of diagnosis and reduce the risks of severe complications due to earlier detection of dangerous forms of the disease.
Переведено сервисом «Яндекс Переводчик»
