Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines

Patricia Rios; Amruta Radhakrishnan; Sonia M. Thomas; Nazia Darvesh; Sharon E. Straus; Andrea C. Tricco

The widespread use of antivirals in institutions that house residents at high risk of severe disease and death from influenza is supported by observational cohort studies and one randomised controlled trial. During an outbreak, other facility residents will have been, or may become, exposed to infectious residents. The provision of antivirals works as early treatment for those incubating disease and reduces shedding in those infected. Data are available to support the premise that this treatment/shedding reduction process prevents continued spread in the facility. (Appendix 16) Antiviral prophylaxis should only be used in addition to other outbreak control measures. The decision to administer antivirals as prophylaxis should be made by the OMT in collaboration with local public health authorities and residents' GPs, depending on local arrangements. If recommended, to optimise the chances of reducing transmission and bring the outbreak under control, antiviral prophylaxis should be given to ALL asymptomatic residents (regardless of vaccination status) and ALL unvaccinated staff.