Guidance on the use of oseltamivir and amantadine for the prophylaxis of influenza | National Resource for Infection Control (NRIC)

Guidance on the use of oseltamivir and amantadine for the prophylaxis of influenza

Best practice, Systematic review
Abstract: 
This guidance pertains only to circumstances where it is known that either influenza A or B is circulating in the community. The guidance has been prepared in the expectation that vaccination against influenza is undertaken in accordance with national guidelines and makes the point that vaccination is the most effective way of preventing illness from influenza and that the drugs described in this guidance are not a substitute for vaccination. The documents outlines guidance on the clinical and cost effectiveness of two antiviral drugs (Oseltamivir and Amantadine) information on the epidemiology of influenza virus A, B and C, the technologies such as licensing, diagnostic testing, administration of the drugs and at risk patient groups who should be included, contra-indications and problems with resistance. The document includes sections on: - - The appraisal process and evidence considered under: - - Clinical effectiveness - Post exposure prophylaxis - Oseltamivir - Seasonal prophylaxis – Amantadine and Oseltamivir - Adverse events - Cost effectiveness - Post exposure prophylaxis - Seasonal prophylaxis - Committee conclusions following review of the evidence on clinical and cost effectiveness - Recommendations for further research - The implications of the guidance for the NHS - Implementation and audit - Related guidance - Review date for this technology appraisal Appendices include sources of evidence considered by the committee, detail on criteria for audit of the use of oseltamivir and amantadine for the prophylaxis of influenza and thresholds for levels of influenza infection. This guidance does not cover the circumstances of a pandemic, impending pandemic or a widespread epidemic of a new strain of influenza to which there is little or no community resistance.
Authors: 
National Institute of Clinical Excellence (NICE)
Category: 
Control
Epidemiology
Management
Treatment

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Summary:
This guidance pertains only to circumstances where it is known that either influenza A or B is circulating in the community. The guidance has been prepared in the expectation that vaccination against influenza is undertaken in accordance with national guidelines and makes the point that vaccination is the most effective way of preventing illness from influenza and that the drugs described in this guidance are not a substitute for vaccination.The documents outlines guidance on the clinical and cost effectiveness of two antiviral drugs (Oseltamivir and Amantadine) information on the epidemiology of influenza virus A, B and C, the technologies such as licensing, diagnostic testing, administration of the drugs and at risk patient groups who should be included, contra-indications and problems with resistance.The document includes sections on: - 1. The appraisal process and evidence considered under: -· Clinical effectiveness§ Post exposure prophylaxis - Oseltamivir§ Seasonal prophylaxis – Amantadine and Oseltamivir· Adverse events· Cost effectiveness§ Post exposure prophylaxis § Seasonal prophylaxis · Committee conclusions following review of the evidence on clinical and cost effectiveness 2. Recommendations for further research 3. The implications of the guidance for the NHS4. Implementation and audit5. Related guidance6. Review date for this technology appraisal Appendices include sources of evidence considered by the committee, detail on criteria for audit of the use of oseltamivir and amantadine for the prophylaxis of influenza and thresholds for levels of influenza infection. This guidance does not cover the circumstances of a pandemic, impending pandemic or a widespread epidemic of a new strain of influenza to which there is little or no community resistance.
Questions Addressed:
The document outlines guidance on the clinical and cost effectiveness of the two antiviral drugs (Oseltamivir and Amantadine) for use as post exposure or seasonal prophylaxis. It provides information on the epidemiology of influenza virus A, B and C, the technologies such as licensing, diagnostic testing, administration of the drugs and at risk patient groups who should be included, contra-indications and problems with resistance.
Type of Study:
Best practice, systematic review
Methods Valid:
Yes
Methods Valid Detail:

This guidance will be reviewed in August 2006

Results Reliability:
Yes
Problems or Biases:

No

Relevant Studies:
Keywords:
influenza vaccination oseltamivir amantadine antiviral drugs.
Reviewer Name:
Sue Wiseman
Reviewer Post:
Nurse Consultant –Infection Control, DH
Reviewer Affiliations:
Member Advisory Committee on Dangerous Pathogens Health Protection Adviser Royal College of Nursing P/T Member Infection Control Nurses Association