FREE subscriptions for doctors and students... click here
You have 3 more open access pages.
The NICE guidance is summarised below:
This guidance has been prepared in the expectation that vaccination against
influenza is undertaken in accordance with national guidelines. Vaccination
is the most effective way of preventing illness from influenza, and the drugs
described in this guidance are not a substitute for vaccination. 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.
- oseltamivir and zanamivir are recommended, within their marketing authorisations,
for the treatment of influenza in adults and children if all the following
circumstances apply:
- national surveillance schemes indicate that influenza virus A or B is
circulating
- the person is in an 'at-risk' group as defined
- the person presents with an influenza-like illness and can start treatment
within 48 hours (or within 36 hours for zanamivir treatment in children)
of the onset of symptoms as per licensed indications
- for the purpose of this guidance, people 'at risk' are defined as those
who have one of more of the following:
- chronic respiratory disease (including asthma and chronic obstructive
pulmonary disease)
- chronic heart disease
- chronic renal disease
- chronic liver disease
- chronic neurological conditions
- diabetes mellitus
- people who are aged 65 years or older and people who might be immunosuppressed
are also defined as 'at-risk' for the purpose of this guidance
- choice of either oseltamivir or zanamivir in the circumstances described
should be made after consultation between the healthcare professional, the
patient and carers
- during localised outbreaks of influenza-like illness (outside the periods
when national surveillance indicates that influenza virus is circulating in
the community), oseltamivir and zanamivir may be offered for the treatment
of influenza in 'at-risk' people who live in long-term residential or nursing
homes. However, these treatments should be offered only if there is a high
level of certainty that the causative agent in a localised outbreak is influenza
(usually based on virological evidence of influenza infection in the initial
case)
- amantadine is not recommended for the treatment of influenza
The NICE guidance does not cover the circumstances of a pandemic or a widespread
epidemic of a new strain of influenza to which there is little community resistance.
For more detailed guidance then consult the full technology appraisal (1).
Reference:
- NICE guidance (February 2009). Guidance
on the use of zanamivir, oseltamivir and amantadine for the treatment of influenza.
Last reviewed 10/2019
Links: