Oseltamivir prophylaxis in controlling influenza outbreak in nursing homes: a comparison between three different approaches

Miksić, Nina Gorišek; Uršič, Tina; Simonović, Zoran; Lusa, Lara; Rojko, P. Lobnik; Petrovec, Miroslav; Strle, Franc

doi:10.1007/s15010-014-0703-4

Cited by 14 publications

(11 citation statements)

References 37 publications

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“…The lack of appropriate treatment and preventive strategies for influenza in ACFs leads to a greater burden of illness and results in poorer outcomes. Whereas there is variable evidence to support the use of OP in ACFs [15], this large cohort study adds to the growing body of evidence on the effectiveness of oseltamivir used prophylactically to prevent influenza in ACFs during an outbreak. This study found that when used as prophylaxis, oseltamivir was highly effective in preventing new clinical cases at an individual level in influenza outbreaks in dementia-specific units and high care settings when compared with nondementia-specific wings and low care settings.…”

Section: Discussionmentioning

confidence: 97%

Effectiveness of Oseltamivir Prophylaxis in Influenza Outbreaks in Residential Aged Care

Dronavalli,

Lord,

Alexander

et al. 2020

JEGH

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Influenza outbreaks in Aged Care Facilities (ACFs) can lead to hospitalizations and deaths. Influenza can spread rapidly through ACFs if precautionary measures are not taken. Along with influenza vaccination and precautionary hygiene measures, Oseltamivir Prophylaxis (OP) may be effective in reducing the attack rate of influenza by preventing new cases. A cohort study was carried out to investigate the effectiveness of OP use during influenza outbreaks in ACFs located within South Western Sydney Local Health District from 1 January 2015 to 31 December 2018. The main outcome assessed was the rate of OP failure (new cases of influenza in patients treated with OP) among ACF residents. Subgroups and various predictors of OP failure were investigated including presence of a dementia ward, high care ward, and days to Public Health Unit (PHU) notification. The cohort consisted of 86 ACF outbreaks involving 10,064 residents. OP prevented 90% of influenza cases during influenza outbreaks [0.1 RR (95% confidence interval (CI): 0.08–0.12); P < 0.0001]. ACFs with dementia wards had a 44% (0.56 relative risk (RR) (95% CI: 0.34–0.93); P < 0.05) lower OP failure rate. ACFs with high level care had an 87% (0.13 RR (95% CI: 0.05–0.38); P < 0.05) lower OP failure rate. OP is highly effective in preventing new cases of influenza during outbreaks in ACFs, especially in ACFs with dementia or high care wards. Mandatory reporting of influenza outbreaks to PHUs would ensure that ACFs are supported throughout the outbreak, which will facilitate reductions in hospitalizations and mortality.

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Section: Discussionmentioning

confidence: 97%

Effectiveness of Oseltamivir Prophylaxis in Influenza Outbreaks in Residential Aged Care

Dronavalli,

Lord,

Alexander

et al. 2020

JEGH

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“…Hospitalisations and deaths were non-influenza specific. 21 Findings from a number of observational and descriptive studies generally favour the recommendation of using antiviral IP to control outbreaks of influenza in the LTCF. 22–26 These studies ranged from case series to uncontrolled cohort studies, before-and-after design, outbreak reports and varied in the sample size, degree and scope of analyses undertaken.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis

Jacobs

Khan

et al. 2016

BMJ Open

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ObjectivesTo evaluate the impact of oseltamivir prophylaxis in the management and control of influenza outbreaks in long-term care facilities in Alberta, Canada.Setting and participantsLong-term care facilities where 127 influenza outbreaks were reported to public health authorities in Alberta, Canada, during two influenza seasons from 2013 to 2015.Design and outcome measuresUsing routinely collected surveillance and administrative data, we examined the association between decision-making time for oseltamivir recommendation as prophylaxis strategy for influenza outbreaks in long-term care facilities (explanatory variable) and the duration of an influenza outbreak, the postprophylaxis risk of influenza-like illness and hospitalisation among residents of long-term care facilities in Alberta (outcome variables) using multivariable linear and Poisson regression models.ResultsOseltamivir prophylaxis decision-making time was positively associated with the postintervention duration of an outbreak, with a 1-day delay in making decision on oseltamivir prophylaxis associated with 2.22 (95% CI 1.37 to 3.06) more days of the duration of an outbreak after controlling for potential confounding effect of the number of residents at risk at intervention, outbreak progression time, prevalence of influenza-like illness during outbreak progression, facility location, presence of mixed strain and based on optimal timing of oseltamivir prophylaxis. Although not statistically significant, a 1-day delay in making decision on oseltamivir prophylaxis was associated with a 5% (95% CI −1% to 11%) increase in the postintervention risk of influenza-like illness, and a 6% (95% CI −8% to 22%) increase in the postintervention risk of hospitalisation after controlling for the same potential confounders.ConclusionsOur study demonstrated benefits of using oseltamivir prophylaxis to shorten the duration of influenza outbreaks; however, there were no significant differences in the influenza-like illness and hospitalisation risk occurring after the intervention. Surveillance data may offer means of rapid evaluation of oseltamivir prophylaxis in long-term care facilities as a public health measure.

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“…Several studies have examined both the clinical and economic benefits of prophylaxis with anti-flu agents ( 21 , 22 ). However, few studies have estimated the efficacy and the cost of prophylaxis of anti-flu agents when an outbreak happens at a single hospital.…”

Section: Discussionmentioning

confidence: 99%

“…The development of resistance when using neuraminidase inhibitors is also unknown. However, the prophylactic usage of oseltamivir is now indicated to manage flu outbreaks for all nursing home residents, as the duration of flu outbreaks was shown to be the shortest in nursing homes where prophylaxis with oseltamivir was given to all residents ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

The Prophylactic Effect of Anti-influenza Agents for an Influenza Outbreak in a University Hospital

et al. 2018

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Objective From November 24 to December 9, 2013, an outbreak of the influenza (flu) A (H3) virus occurred in a tertiary-care university hospital (1,014 beds). We herein report the prophylactic effect of anti-flu agents for controlling the flu outbreak. Methods We administered pre- or post-exposure prophylaxis with anti-flu agents in flu outbreak. To test the effectiveness of prophylaxis in a flu outbreak, we used the posterior mean of the reproductive value during the pre- and post-intervention period. We also simulated the probability distribution of new flu cases. We performed an analysis to quantify the strength of the intervention effect. Results A total of 97 people were diagnosed with flu before the intervention, and 7 were diagnosed after the intervention. A molecular analysis of the flu virus revealed that this outbreak was due to the flu A (H3) virus. A total of 3,702 people received prophylaxis. There was a significant reduction in the reproductive value from 1.89 [95% confidence interval (CI), 1.59 to 2.24] to 0.65 (95% CI, 0.02 to 1.00) after the intervention (p<0.001). Conclusion Prophylaxis with anti-flu agents, along with prompt identification and isolation of infected individuals, was effective in reducing the impact of a flu outbreak in a hospital.

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Oseltamivir prophylaxis in controlling influenza outbreak in nursing homes: a comparison between three different approaches

Abstract: Comparison of influenza outbreaks in three NHs revealed that the duration of the outbreak was the shortest in the NH where prophylaxis with oseltamivir was given to all residents.

Cited by 14 publications

References 37 publications

Effectiveness of Oseltamivir Prophylaxis in Influenza Outbreaks in Residential Aged Care

Effectiveness of Oseltamivir Prophylaxis in Influenza Outbreaks in Residential Aged Care

Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis

The Prophylactic Effect of Anti-influenza Agents for an Influenza Outbreak in a University Hospital

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