Give antiviral chemoprophylaxis to all non-ill residents (regardless of vaccination status) during influenza outbreak1

By vgreene, 15 December, 2014
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<sup>1</sup> Outbreak is likely when ≥2 residents are ill w/in 72h and ≥1 has lab-confirmed influenza. When influenza viruses are circulating in community, even 1 positive lab result in conjunction w/ other compatible illnesses on the unit indicates a likely outbreak. <br><br>
<sup>2</sup> <b>Oseltamivir renal dosing in adults:</b><br>
• CrCl 61-90 mL/min: 75 mg PO once daily<br>
• CrCl 31-60 mL/min: 30 mg PO once daily<br>
• CrCl 11-30 mL/min: 30 mg PO every other day<br>
• ESRD on hemodialysis only (CrCl ≤10 mL/min): 30 mg PO after alternate HD cycles (can administer initial dose prior to start of dialysis)<br>
• CAPD (CrCl ≤10 mL/min): 30 mg PO once weekly immediately after dialysis exchange
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<sup>3</sup> <b>Oseltamivir adverse events:</b> nausea, vomiting, HA. Post marketing reports of serious skin rxns and sporadic, transient neuropsychiatric events.
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<sup>4</sup> <b>Zanamivir renal dosing:</b> No dose adjustment recommended for pts w/ renal impairment.
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<sup>5</sup> Zanamivir not recommended if underlying respiratory dz (asthma, COPD, etc) or allergy to milk protein.
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<b>Zanamivir adverse events:</b> bronchospasm risk, esp if underlying airways dz; sinusitis and dizziness. Post marketing reports of serious skin reactions and sporadic, transient neuropsychiatric events.
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Give antiviral chemoprophylaxis to all non-ill residents (regardless of vaccination status) during influenza outbreak<sup>1</sup>