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Guidance on the use of antiviral drugs for the prevention of influenza

  • Last modified date:
    9 February 2007

NICE guidance notes on prescribing antiviral drugs.

Influenza Season 2004/05 - 6th April 2005

'Low levels of influenza activity indicate that it is no longer appropriate to prescribe antiviral drugs for the treatment or prevention of influenza.

Influenza activity has continued to decline in recent weeks and is now at a low level. Consultations for influenza-like illness with the Royal College of General Practitioners (RCGP) in England are in the 'baseline' range and virological surveillance indicates that influenza viruses are no longer circulating in the community in significant numbers.

In line with NICE guidance, the routine use of antiviral drugs for the prevention or treatment of influenza is no longer recommended although they should still be considered when outbreaks among at-risk groups are reported.'

The National Institute of Clinical Excellence (NICE) guidance on antiviral drugs

  1.  Guidance on the use of antiviral drugs for the prevention of influenza
  2.  Guidance on the use of antiviral drugs for the treatment of influenza
  3.  Further information

1. Guidance on the use of antiviral drugs for the prevention of influenza (prophylaxis)

New guidance on the use of antiviral drugs for the prevention of influenza was announced on the 24th September 2003.  NICE recommends that when influenza A or B virus is circulating in the community, oseltamivir should be prescribed for the prevention of influenza to those aged 13 years or older who fulfil the following criteria:

People aged 13 years or older who

  • belong to an 'at-risk' group, and
  • have not had a flu jab this season, or who had one but too recently for it to have given good protection, or have had a flu jab but the vaccine does not match the virus circulating in the community, and
  • have been in close contact with someone with flu-like symptoms, and
  • can start taking oseltamivir within 48 hours of being in contact with the person with flu-like symptoms.

Oseltamivir should not be used for the prevention of influenza in otherwise healthy people under 65 years of age, even if they have been in contact with people with flu-like symptoms.

Amantadine should not be used for the prevention of influenza in either group.

2. Guidance on the use of antiviral drugs for the treatment of influenza

Updated guidance on the on the use of amantadine, oseltamivir and zanamivir for the treatment of influenza was issued in February 2003.

Within its licensed indications, Zanamivir and oseltamivir are recommended for the treatment of influenza in adults who present with influenza-like illness (and oseltamivir for the treatment of at-risk children) and who can start treatment within 48 hours of the onset of symptoms.

Amantadine is not recommended for the treatment of influenza.

3. Further information

For more detailed information on the NICE guidance refer to the NICE website

Influenza activity in England and Wales

Information on the GP consultation rates for influenza/influenza-like illness is collected by the Royal College of General Practitioners (RCGP).  Weekly updates on the consultation rates are published on the RCGP website. Weekly reports from the Health Protection Agency on current influenza activity can be found on the Health Protection Agency website.

The first line of defence against flu for 'at-risk' individuals is immunisation with influenza vaccine.

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