Assessment of Adherence to Post-exposure Prophylaxis with Oseltamivir in Healthcare Workers: A Retrospective Questionnaire-Based Study

Okada, Naoto; Fujiwara, Noriko; Azuma, Momoyo; Tsujinaka, Kaito; Chuma, Masayuki; Yagi, Kenta; Hamano, Hirofumi; Aizawa, Fuka; Goda, Mitsuhiro; Kirino, Yasushi; Nakamura, Teruya; Zamami, Yoshito; Hashimoto, Ichiro; Ishizawa, Keisuke

doi:10.1248/bpb.b21-00165

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…With an effective viral suppressive effect [64,84 ▪ ,92,93] and a low risk of adverse events, baloxavir is superior to placebo [72 ▪ ] and oseltamivir [94 ▪ ] as PEP. PEP non-compliance is a major concern, as 63.1% of healthcare workers did not complete oseltamivir PEP in a survey [95]. PEP using single-dose antiviral may be advantageous in avoiding compliance issues.…”

Section: Use Of Antiviral Agents To Control the Spread Of Influenza I...mentioning

confidence: 99%

Antiviral therapies for influenza

Chan

Hui

2023

Current Opinion in Infectious Diseases

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Purpose of reviewThe heavily suppressed global influenza activity during the coronavirus disease 2019 (COVID-19) pandemic is expected to return upon relaxation of travel restriction and nonpharmaceutical interventions (NPI). We reviewed the four marketed neuraminidase inhibitors (NAI e.g., oseltamivir, zanamivir, peramivir, laninamivir) and the only endonuclease inhibitor (baloxavir) on their clinical therapeutic effects and the ability of viral suppression in various groups of patients of different clinical settings based on the latest evidence.Recent findingsEarly initiation, preferably within 48 h of symptom onsets, of antiviral treatments with NAI and baloxavir, is crucial to produce favourable outcomes in patients with influenza infection. Updated evidence does not suggest routine use of combined antiviral agents in patients with influenza infection. Treatment-emergent resistant influenza variants may occur during NAI and baloxavir use, but it has no major impact on subsequent recovery. Early treatment of index patients with influenza infection and post-exposure prophylaxis in specific populations is crucial in preventing influenza transmission.SummaryAntiviral therapy is the major defence therapeutically in the community and hospital settings to expedite early recovery and reduce influenza-related complications. Early treatment of index patients and post-exposure prophylaxis in susceptible close contacts may mitigate the spread of infection.

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Section: Use Of Antiviral Agents To Control the Spread Of Influenza I...mentioning

confidence: 99%

Antiviral therapies for influenza

Chan

Hui

2023

Current Opinion in Infectious Diseases

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Modeling the Impacts of Antiviral Prophylaxis Strategies in Mitigating Seasonal Influenza Outbreaks in Nursing Homes

Morris,

Zipfel,

Peer

et al. 2023

Clinical Infectious Diseases

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Background Antiviral chemoprophylaxis is recommended for use during influenza outbreaks in nursing homes to prevent transmission and severe disease among non-ill residents. Centers for Disease Control and Prevention (CDC) guidance recommends prophylaxis be initiated for all non-ill residents once an influenza outbreak is detected and be continued for at least 14 days and until seven days after the last laboratory-confirmed influenza case is identified. However, not all facilities strictly adhere to this guidance and the impact of such partial adherence is not fully understood. Methods We developed a stochastic compartmental framework to model influenza transmission within an average-sized U.S. nursing home. We compared the number of symptomatic illnesses and hospitalizations under varying prophylaxis implementation strategies, in addition to different levels of prophylaxis uptake and adherence by residents and healthcare personnel (HCP). Results Prophylaxis implemented according to current guidance reduced total symptomatic illnesses and hospitalizations among residents by an average of 12% and 36%, respectively, compared with no prophylaxis. We did not find evidence that alternative implementations of prophylaxis were more effective: compared to full adoption of current guidance, partial adoption resulted in increased symptomatic illnesses and/or hospitalizations, and longer or earlier adoption offered no additional improvements. In addition, increasing uptake and adherence among nursing home residents was effective in reducing resident illnesses and hospitalizations, but increasing HCP uptake had minimal indirect impacts for residents. Conclusions The greatest benefits of influenza prophylaxis during nursing home outbreaks will likely be achieved through increasing uptake and adherence among residents and following current CDC guidance.

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Prescription factors influencing baloxavir prescription during the 2018/2019 and 2019/2020 seasons: a administrative database study in Japan

Fujiwara

Fujiwara²,

Ise

2023

J Pharm Health Care Sci

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Background We aimed to evaluate the factors associated with baloxavir prescription in Japanese hospitals using a health insurance claim-based database (MDV analyzer), during the 2018/2019 and 2019/2020 influenza seasons. The MDV analyzer contains anonymized claims data from approximately 420 Diagnosis Procedure Combination hospitals, and does not contain data from clinics. Methods Data were collected for influenza patients treated with anti-influenza drugs during the 2018/2019 and 2019/2020 influenza seasons. Multivariate analysis was used to identify factors associated with baloxavir prescription. Results During the study period, 322,063 influenza patients were included for analyses. In multivariate analysis, children, female sex, inpatient, hospital bed capacity, and private hospitals were negatively associated with baloxavir prescription. Compared to elderly patients, the adjusted odds ratio (OR) for baloxavir prescription was 0.612 (95% confidence interval (CI), 0.587–0.637) in children aged 6–11 years, and 0.119 (95% CI, 0.111–0.128) in children aged 0–5 years. Compared to small hospitals (bed capacity, 20–299), the adjusted OR for baloxavir prescription was 0.559 (95% CI, 0.540–0.578) in large hospitals (bed capacity, ≥ 500). Conclusion Children, female sex, inpatient, hospital bed capacity, and private hospitals were negatively associated with baloxavir prescription.

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Assessment of Adherence to Post-exposure Prophylaxis with Oseltamivir in Healthcare Workers: A Retrospective Questionnaire-Based Study

Cited by 3 publications

References 25 publications

Antiviral therapies for influenza

Antiviral therapies for influenza

Modeling the Impacts of Antiviral Prophylaxis Strategies in Mitigating Seasonal Influenza Outbreaks in Nursing Homes

Prescription factors influencing baloxavir prescription during the 2018/2019 and 2019/2020 seasons: a administrative database study in Japan

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