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Prophylaxis Strategies Reduce Nursing Home Flu Outbreaks

Post-exposure prophylaxis with oseltamivir may be more effective than continuous prophylaxis

THURSDAY, Sept. 10 (HealthDay News) -- During annual influenza epidemics, prophylaxis with oseltamivir in nursing homes may significantly reduce the number of infections, according to a study published online Sept. 10 in Emerging Infectious Diseases.

Carline van den Dool, a Ph.D. candidate at the University Medical Center in Utrecht, Netherlands, and colleagues used a stochastic individual-based model to simulate influenza virus outbreaks during an 80-day period in a typical Dutch long-term care nursing home and studied the effects of post-exposure and continuous oseltamivir prophylaxis.

In the absence of oseltamivir resistance, the researchers found that post-exposure and continuous prophylaxis significantly decreased the infection attack rate among patients (relative risks, 0.67 and 0.23, respectively), and that the number of daily doses needed to prevent one infection was lower for post-exposure than continuous prophylaxis (118 versus 323). With increased resistance to oseltamivir, however, they found that both prophylaxis strategies were significantly less effective.

"Our findings indicate that increasing resistance should be included in the decision-making process for prevention of influenza in health care settings," the authors write. "Use of other antiviral agents that are not as associated with resistance should be considered as an alternative prevention strategy. Household studies suggest that prophylaxis with zanamivir, for example, can give similar results as prophylaxis with oseltamivir."

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