Duration of Antiviral Prophylaxis During Nursing Home Outbreaks of Influenza A

Drinka, Paul J.; Gravenstein, Stefan; Schilling, Margo; Krause, Peggy; Miller, Barbara A.; Shult, Peter

doi:10.1001/archinte.158.19.2155

Cited by 39 publications

(23 citation statements)

References 14 publications

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“…Three studies compared influenza vaccination with placebo [97,99,100] and two with usual care [98,103]. Six evaluated neuraminidase inhibitors [107-112]. …”

Section: Resultsmentioning

confidence: 99%

A systematic mapping review of Randomized Controlled Trials (RCTs) in care homes

et al. 2012

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BackgroundA thorough understanding of the literature generated from research in care homes is required to support evidence-based commissioning and delivery of healthcare. So far this research has not been compiled or described. We set out to describe the extent of the evidence base derived from randomized controlled trials conducted in care homes.MethodsA systematic mapping review was conducted of the randomized controlled trials (RCTs) conducted in care homes. Medline was searched for “Nursing Home”, “Residential Facilities” and “Homes for the Aged”; CINAHL for “nursing homes”, “residential facilities” and “skilled nursing facilities”; AMED for “Nursing homes”, “Long term care”, “Residential facilities” and “Randomized controlled trial”; and BNI for “Nursing Homes”, “Residential Care” and “Long-term care”. Articles were classified against a keywording strategy describing: year and country of publication; randomization, stratification and blinding methodology; target of intervention; intervention and control treatments; number of subjects and/or clusters; outcome measures; and results.Results3226 abstracts were identified and 291 articles reviewed in full. Most were recent (median age 6 years) and from the United States. A wide range of targets and interventions were identified. Studies were mostly functional (44 behaviour, 20 prescribing and 20 malnutrition studies) rather than disease-based. Over a quarter focussed on mental health.ConclusionsThis study is the first to collate data from all RCTs conducted in care homes and represents an important resource for those providing and commissioning healthcare for this sector. The evidence-base is rapidly developing. Several areas - influenza, falls, mobility, fractures, osteoporosis – are appropriate for systematic review. For other topics, researchers need to focus on outcome measures that can be compared and collated.

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“…Three studies compared influenza vaccination with placebo [97,99,100] and two with usual care [98,103]. Six evaluated neuraminidase inhibitors [107-112]. …”

Section: Resultsmentioning

confidence: 99%

A systematic mapping review of Randomized Controlled Trials (RCTs) in care homes

et al. 2012

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“…The CDC, numerous state and local public health agencies, and experts on influenza control recommend that antiviral chemoprophylaxis during an institutional influenza outbreak should be administered for no less than 14 days and that, if surveillance indicates that new cases continue to occur, chemoprophylaxis should be continued until 7 days after the last case has been identified [5,94,214,229]. One randomized trial that compared 2 antiviral chemoprophylaxis protocols used during nursing home outbreaks of influenza A concluded that administration of antivirals to residents for a minimum of 14 days (and for 7 days after the last confirmed influenza case) was sufficient to prevent recrudescence of the outbreak [229].…”

Section: Recommendationmentioning

confidence: 99%

Seasonal Influenza in Adults and Children—Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America

Harper

Bradley

Englund

et al. 2009

Clinical Infectious Diseases

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595

543

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Guidelines for the treatment of persons with influenza virus infection were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic issues, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal (interpandemic) influenza. They are intended for use by physicians in all medical specialties with direct patient care, because influenza virus infection is common in communities during influenza season and may be encountered by practitioners caring for a wide variety of patients.

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“…From a single government‐payer perspective, a decision analytic model was developed with a 30‐day time frame. Thirty days reflects the approximate length of one institutional outbreak 25 . The model is illustrated in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Economic Evaluation of Oseltamivir Phosphate for Postexposure Prophylaxis of Influenza in Long‐Term Care Facilities

Risebrough¹,

Bowles²,

Simor³

et al. 2005

J American Geriatrics Society

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Despite high influenza vaccination rates, influenza outbreaks continue to emerge in LTCFs, necessitating cost-effective measures to further limit the spread of influenza and related complications. Although amantadine has a lower acquisition cost than oseltamivir, it is associated with more adverse events, lower efficacy, and individualized dosing requirements, leading to higher overall costs and more influenza-like illness cases than oseltamivir. Therefore the use of oseltamivir postexposure prophylaxis is more cost-effective than the current standard of care with amantadine prophylaxis or no prophylaxis.

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Duration of Antiviral Prophylaxis During Nursing Home Outbreaks of Influenza A

Cited by 39 publications

References 14 publications

A systematic mapping review of Randomized Controlled Trials (RCTs) in care homes

A systematic mapping review of Randomized Controlled Trials (RCTs) in care homes

Seasonal Influenza in Adults and Children—Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America

Economic Evaluation of Oseltamivir Phosphate for Postexposure Prophylaxis of Influenza in Long‐Term Care Facilities

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