This guidance from the Department of Health follows on from the CAS alert and letter sent to healthcare professionals sent last Thursday.
Primary care prescribers are restricted to only prescribe antiviral medicines (i.e. oseltamivir and zanamavir) to clinical at risk groups, pregnant women, people over the age of 65 years and those people under 65 years of age who are not in clinical at risk groups but are clinically assessed to be at risk of developing medical complications from influenza.
Clinicians in secondary care are not subject to the restrictions that apply in primary care to prescribing of antiviral medicines, and can therefore use their clinical judgment to prescribe antiviral medicines, including for those not in the clinical at risk groups. For clinicians treating hospitalised patients with suspected influenza, rapid laboratory confirmation with subtype identification is advised, to support patient management.
The use of antiviral medicines is supported by NICE Technology Appraisal 168: “Amantadine, oseltamivir and zanamivir for the treatment of influenza”, which recommends oseltamivir or zanamivir (but not amantadine) in at risk patients when 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
Maximising uptake of flu vaccination, including healthcare staff is also highlighted as an important strategy for ensuring maximum protection and minimising the risk of transmission.