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Adverse Effects of Amantadine and Oseltamivir Used During Respiratory Outbreaks in a Center for Developmentally Disabled Adults

Published online by Cambridge University Press:  02 January 2015

Allison J. McGeer ,
Wayne Lee ,
Mark Loeb ,
Andrew E. Simor ,
Margaret McArthur ,
Karen Green ,
Jonathan Hayfron Benjamin  and
Charles Gardner
Allison J. McGeer*
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Wayne Lee
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Mark Loeb
Affiliation:
Department of Microbiology, Hamilton Health Sciences Corporation, McMaster University, Hamilton, Ontario, Canada
Andrew E. Simor
Affiliation:
Department of Microbiology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Margaret McArthur
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Karen Green
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Jonathan Hayfron Benjamin
Affiliation:
Rideau Regional Centre, Smith Falls, Ontario, Canada
Charles Gardner
Affiliation:
Leeds, Grenville and Lanark District Health Unit, Brockville, Ontario, Canada
*
Room 1460, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, CanadaM5G 1X5
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Abstract

Background And Objectives:

Antiviral prophylaxis is recommended for the control of institutional influenza A outbreaks. In long-term–care institutions other than nursing homes, neither the seriousness of influenza nor the risks and benefits of antiviral prophylaxis is clearly understood. We studied the severity of illness due to influenza among adults residing in a center for the developmentally disabled and assessed adverse reactions to amantadine and oseltamivir prophylaxis.

Methods:

Data were collected from the charts of consenting residents. Complications of upper respiratory tract illness were recorded. Potential adverse events were documented during amantadine and oseltamivir therapy, and during a baseline period with neither medication.

Results:

The median age of the 287 participants was 46.4 years. Only 15 (5%) were older than 65 years, and 69 (24%) had chronic underlying medical illness placing them at high risk for influenza. Of the 122 residents with an upper respiratory tract infection, 16 (13%) developed pneumonia, 12 (9.8%) were hospitalized, and 5 (4%) died. Twenty-eight (25%) of 112 residents had an adverse neurologic event while receiving amantadine prophylaxis, compared with 3 (2.7%) receiving no antiviral medication and 5 (4.5%) receiving oseltamivir (P < .001). Sixteen percent of the residents discontinued amantadine due to adverse events; in contrast, adverse events were identified in 2.9% of the residents prescribed oseltamivir, and none discontinued therapy.

Conclusions:

Viral respiratory tract infections are associated with a high risk of complications in this population. The rate of adverse neurologic events associated with amantadine was significantly higher than that associated with oseltamivir.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 955 - 961
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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