Use of oseltamivir in Dutch nursing homes during the 2004-2005 influenza season.
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.
van der Sande
Marianne A B
MA
Centre for Infectious Disease Epidemiology, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. marianne.van.der.sande@rivm.nl
Ruijs
Wilhelmina L M
WL
Meijer
Adam
A
Cools
Herman J M
HJ
van der Plas
Simone M
SM
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
D000998:Antiviral Agents; D053139:Oseltamivir