Japanese Society for Infection Prevention and Control-Online Journal

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Efficacy of a Three-day Regimen of Oseltamivir for Post-exposure Prophylaxis for Influenza

Yuka KUDO¹⁾, Masanori MATSUKAWA²⁾, Yukari KUDO²⁾, Yutaka HIRATA²⁾, Takashi ABE¹⁾²⁾ and Tomomi KAZUNO¹⁾
¹⁾Department of Clinical Laboratory, Takikawa Municipal Hospital, ²⁾Infection Control Team, Takikawa Municipal Hospital

A 7-10 day course of post-exposure prophylaxis (PEP) with a neuraminidase inhibitor for influenza is recommended for inpatients. Since it was reported that a three-day regimen had a prophylactic effect comparable to the longer regimen, we shortened the PEP duration in our infection control manual. Inpatients who had been in close contact with index patients with influenza were given oseltamivir 75 mg once daily for three days as a general rule. In cases with a higher risk of an outbreak, healthcare personnel were also offered oseltamivir 75 mg once daily for seven days at the suggestion of the infection control team. We retrospectively investigated all cases who received any kind of PEP in the last two seasons in our hospital, and evaluated the prophylactic effect of the three-day regimen. From November 2016 to April 2018, there were 42 events requiring PEP for inpatients or healthcare personnel. The sources of exposure were 25 healthcare personnel and 17 inpatients, and the influenza virus types consisted of 31 of type A, 10 of type B, and one unidentified type. PEP was used in 339 cases (inpatients, 250 cases; healthcare personnel, 89 cases). The drugs used were as follows: oseltamivir, 296 cases; laninamivir, 41 cases; zanamivir, one case; peramivir, one case. Oseltamivir was administered in 88 cases (healthcare personnel) for seven days, 123 cases (inpatients) for three days, 3 cases (inpatients with impaired renal function) for two days, and 81 cases (hemodialysis patients) for one day. One of the 123 oseltamivir was a three-day-regimen case, and one of the 41 laninamivir cases developed type-A influenza.
In this study, the prophylactic efficacy of the three-day regimen of oseltamivir as PEP was 99.2%, which is comparable to that of longer, previously reported regimens. We believe that the three-day regimen as PEP for influenza is sufficiently efficacious for inpatients.

Key words：influenza, post-exposure prophylaxis, oseltamivir

e-mail: saikin＠med.takikawa.hokkaido.jp

Received: October 26, 2018
Accepted: February 26, 2019

34 (3)：155─161,2019