Influenza outbreak in a long-term-care facility: Considerations for pharmacy

The role played by a hospital pharmacy department in managing an influenza outbreak at an affiliated long-term-care facility is described. In February 1998 an outbreak of influenza A was confirmed in a 570-bed long -term-care facility. During the outbreak, a total of 48 cases of influenza- like illness (ILI) were reported to infection control, and 62 staff members missed work because of ILI. Infection control measures included a recommen dation for prophylaxis with amantadine. Pharmacists assumed responsibility for educating patients and families about amantadine prophylaxis, providing individualized dosing, evaluating reported adverse effects, and drug distr ibution. Pharmacists developed an information sheet on amantadine for patie nts and met with patients and their families. The overall acceptance rate f or chemoprophylasis was 91%. Of the 349 patients receiving amantadine during the outbreak, 203 (58%) wer e given 100 mg daily, 136 (39%) were given 100 mg every other day, and 10 ( 3%) were prescribed 100 mg weekly. Pharmacists confirmed a total of 22 adve rse effects; generally the problem was solved by reducing the dosage rather than discontinuing the drug. In all cases, the first dose of amantadine wa s provided to the nursing units within three hours of an order being writte n. Pharmacists played an active role in managing an influenza A outbreak at a long-term-care facility.