title: Use of oseltamivir in Dutch nursing homes during the 2004-2005 influenza season.
abstract: To assess the implementation of guidelines for using neuraminidase inhibitors in the control of influenza outbreaks in Dutch nursing homes, data were collected on prophylactic and therapeutic use of anti-viral medication, indications for use and criteria for prescribing, based on experiences during the influenza season 2004-2005 in a retrospective cross-sectional survey among Dutch nursing homes after the 2004-2005 season. Ninety/194 (49%) participating nursing homes reported an outbreak of influenza-like illness; in 57/194 (29%) influenza was laboratory confirmed. In 37/57 homes (65%) oseltamivir had been used as prophylaxis. Prophylactic use was extended to all residents and staff in 6/37 (16%) of homes, but limited in the others. In 9/37 (24%) no staff were issued prophylaxis. Among clinicians with laboratory confirmed influenza, 41/46 (89%) had used oseltamivir therapeutically. Main reasons for not prescribing oseltamivir for prophylaxis and/or therapy were lack of scientific evidence, high costs, and absent or delayed laboratory confirmation. Logistical bottlenecks in diagnosis, cost-effectiveness concerns, and lack of an evidence-base hamper full integration in policy and should be addressed.
authors.affiliation: Centre for Infectious Disease Epidemiology, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. marianne.van.der.sande@rivm.nl
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: van der Sande
authors.forename: Wilhelmina L M
authors.initials: WL
authors.lastname: Ruijs
authors.forename: Adam
authors.initials: A
authors.lastname: Meijer
authors.forename: Herman J M
authors.initials: HJ
authors.lastname: Cools
authors.forename: Simone M
authors.initials: SM
authors.lastname: van der Plas
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006287:Health Planning Guidelines; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D009735:Nursing Homes; D053139:Oseltamivir / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011322:Primary Prevention; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir