tetano
Editor, Senior Moderator
Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial.
Booy R, Lindley RI, Dwyer DE, Yin JK, ..., Dobbins T, Philp DJ, Gao Z, Macintyre CR.
PLoS ONE. 2012; 7(10):e46509
Average rating:
Jonathon Truwit, University of Virginia Health System, VA, USA. F1000 Respiratory Disorders
10 Dec 2012 | Clinical Trial, Clinical Trial: RCT
DOI: 10.3410/f.717962175.793466493
Influenza is a serious illness in the elderly. Geography of aged-care facilities may enhance person-to-person spread of the virus and thus place community members at greater risk. This study randomized aged-care facilities to provide consenting residents and staff either treatment with oseltamivir 75mg bid for 5 days for those with influenza or influenza-like illness (T; treatment) or oseltamivir 75mg daily for 10 days for all consenting residents and staff, regardless of symptoms of influenza (T&P; treatment and prophylaxis). The T&P group had shorter duration of influenza outbreaks than the T group (10.8 days vs. 24.0, p=0.03). The resident attack rate ratio was 0.63 (95% CI:0.47 to 0.84, p=0.002) favoring the T&P group. Death, hospitalization and pneumonia rates were similar in both groups, as were drug side effects.
This study suggests potential benefit to a T&P approach to an influenza outbreak in the setting of an aged-care facility. However, the study is underpowered as influenza outbreaks were less prevalent and consents could not always be obtained within the outbreak period. Furthermore, we do not know the impact of implementing such an intervention across a multitude of aged-cared facilities on oseltamivir resistance. This could have worldwide impact.
At this point, I cannot support the practice of a T&P approach to an influenza outbreak in the setting of an aged-care facility, both from a benefit and environmental impact.
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046509
Booy R, Lindley RI, Dwyer DE, Yin JK, ..., Dobbins T, Philp DJ, Gao Z, Macintyre CR.
PLoS ONE. 2012; 7(10):e46509
Average rating:
Jonathon Truwit, University of Virginia Health System, VA, USA. F1000 Respiratory Disorders
10 Dec 2012 | Clinical Trial, Clinical Trial: RCT
DOI: 10.3410/f.717962175.793466493
Influenza is a serious illness in the elderly. Geography of aged-care facilities may enhance person-to-person spread of the virus and thus place community members at greater risk. This study randomized aged-care facilities to provide consenting residents and staff either treatment with oseltamivir 75mg bid for 5 days for those with influenza or influenza-like illness (T; treatment) or oseltamivir 75mg daily for 10 days for all consenting residents and staff, regardless of symptoms of influenza (T&P; treatment and prophylaxis). The T&P group had shorter duration of influenza outbreaks than the T group (10.8 days vs. 24.0, p=0.03). The resident attack rate ratio was 0.63 (95% CI:0.47 to 0.84, p=0.002) favoring the T&P group. Death, hospitalization and pneumonia rates were similar in both groups, as were drug side effects.
This study suggests potential benefit to a T&P approach to an influenza outbreak in the setting of an aged-care facility. However, the study is underpowered as influenza outbreaks were less prevalent and consents could not always be obtained within the outbreak period. Furthermore, we do not know the impact of implementing such an intervention across a multitude of aged-cared facilities on oseltamivir resistance. This could have worldwide impact.
At this point, I cannot support the practice of a T&P approach to an influenza outbreak in the setting of an aged-care facility, both from a benefit and environmental impact.
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046509