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| LETTER TO THE EDITOR |
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| Year : 2013 | Volume
: 45
| Issue : 3 | Page : 313-314 |
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Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand; Visiting professor, Hainan Medical University, China; Visiting Professor, Faculty of Medicine, University of Nis, Serbia; Adjunct Professor, Joseph Ayobabalola University, Nigeria
| Date of Web Publication | 15-May-2013 |
Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand; Visiting professor, Hainan Medical University, China; Visiting Professor, Faculty of Medicine, University of Nis, Serbia; Adjunct Professor, Joseph Ayobabalola University
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0253-7613.111928
How to cite this article:
Wiwanitkit V. Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir. Indian J Pharmacol 2013;45:313-4 |
Sir,
The recent report by Samra et al., on the risk of H1N1-chemoprophylaxis with oseltamivir among the health care personnel (HCP) is very interesting. [1] Samra et al., concluded thus: "Chemoprophylaxis with oseltamivir is not recommended for HCP working in areas of high aerosol generation like ICU, if infection control measures are adopted as there is no significant difference in the incidence of flu-like illness in HCP with and without intake of oseltamivir." [1] Based on the findings in the present study, it seems that the chemoprophylaxis by oseltamivir is useless and the adverse effect is of serious concern. Indeed, there is no doubt that adverse effect of oseltamivir can be observed. [2] However, the question is whether the risk of adverse effect is higher than the benefit of using it. Indeed, oseltamivir is accepted as a standard drug for both therapeutic and prophylactic purposes. [3] There is no doubt that the medical personnel are at risk for getting H1N1 infection. The study by Samra et al., focused on the specific worker dealing with intensive care unit. In real life, there are many other medical workers at high risk but they are usually forgotten. The risk to get infection will be significantly higher among those with low experience and education (such as hospital maid, [4] medical students, [5],[6] etc.). Focusing on the common adverse effects of oseltamivir, nausea and vomiting are confirmed as the cause of incomplete of oseltamivir use in prophylaxis course. [7] However, it is not confirmed that the prophylaxis is not useful and downgraded by the drug's adverse effect. In a large-scale surveillance during the epidemic, Strong et al., concluded that mass distribution of oseltamivir was more useful than targeted distribution. [7] Based on the mathematical simulation model, it is proved that prophylaxis, either pre- or post- exposure alternative, is better than no prophylaxis. [8]
| » References | |  |
| 1. | Samra T, Pawar M. Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir. Indian J Pharmacol 2012;44:754-8. 
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| 2. | Wiwanitkit S, Wiwanitkit V. Adverse drug reaction of oseltamivir in pediatric patients. J Pharmacol Pharmacother 2012;3:81.
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| 3. | Wiwanitkit V. Antiviral drug treatment for emerging swine flu. Clin Ter 2009;160:243-5.
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| 4. | Wiwanitkit V. Hospital maid: A worker at risk of contracting swine flu. Int J Occup Environ Med 2010;1:144-5.
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| 5. | Wiwanitkit V. Pre-clinical year medical students: At-risk of contracting swine flu. Hong Kong Med J 2010;16:158-9.
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| 6. | Wiwanitkit V. Swine flu infection among medical students: an issue of concern. Am J Infect Control 2009;37:868.
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| 7. | Strong M, Burrows J, Stedman E, Redgrave P. Adverse drug effects following oseltamivir mass treatment and prophylaxis in a school outbreak of 2009 pandemic influenza A(H1N1) in June 2009, Sheffield, United Kingdom. Euro Surveill 2010;15:pii/19565.
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| 8. | van den Dool C, Hak E, Bonten MJ, Wallinga J. A model-based assessment of oseltamivir prophylaxis strategies to prevent influenza in nursing homes. Emerg Infect Dis 2009;15:1547-55.
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