Tamiflu Prophylaxis for Healthcare Workers During Retirement Home Outbreaks
Recommended Dose and Administration
- The Centers for Disease Control and Prevention recommends a dose of 75 mg orally once daily for healthy adults working in a retirement home during an influenza outbreak, continued for at least 2 weeks and up to 6 weeks during a community outbreak 1, 2, 3
- The American Academy of Pediatrics suggests that the standard prophylactic dose is 75 mg once daily, which can be taken with or without food, though taking with meals may reduce gastrointestinal side effects 2
Outbreak-Specific Considerations
- The Centers for Disease Control and Prevention advises that chemoprophylaxis should be initiated as soon as influenza is identified in the facility and continued for a minimum of 2 weeks, and if surveillance indicates new cases continue to occur, prophylaxis should be continued until approximately 1 week after the end of the outbreak 1, 3
- Chemoprophylaxis can be offered to unvaccinated staff members who provide care to high-risk persons, and should be considered for all employees regardless of vaccination status if the outbreak is suspected to be caused by a strain not well-matched to the vaccine 1, 3
Safety and Tolerability
- Taking oseltamivir with food significantly improves gastrointestinal tolerability, according to the American Academy of Pediatrics 2
- The Centers for Disease Control and Prevention recommends avoiding live attenuated influenza vaccine (LAIV) within 48 hours before oseltamivir use, and not using oseltamivir for 14 days after LAIV vaccination 5
Institutional Outbreak Control
- The Centers for Disease Control and Prevention advises that to limit transmission of drug-resistant virus, contact between persons taking antivirals for treatment and those taking prophylaxis should be reduced 1, 3
- No renal adjustment is needed for healthy adults with normal renal function, according to the Centers for Disease Control and Prevention 1, 3