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Antimicrob Agents Chemother. Oct 1995; 39(10): 2224–2228.
PMCID: PMC162919

Safety and efficacy of long-term use of rimantadine for prophylaxis of type A influenza in nursing homes.

Abstract

The safety and efficacy of rimantadine for long-term prophylaxis of influenza A (H3N2) infection were evaluated among elderly residents in 10 nursing homes. Within each nursing home, participating residents were randomly assigned to receive placebo or rimantadine at 100 or 200 mg/day. Residents were evaluated daily for symptoms and significant health events as possible side effects, as well as for influenza-like illness. The study medications were administered to 328 residents for up to 8 weeks, with no statistically significant differences in the frequencies of gastrointestinal or central nervous system symptoms between the groups. However, residents in the active medication groups were more likely to withdraw from the study and to experience various health events including death; some but not all of these differences were statistically significant. Efficacy evaluations were carried out on the 68 vaccinated residents in the two nursing homes with demonstrated influenza virus activity. Rimantadine appeared to provide an additional protective effect beyond vaccination in reducing the risk of clinical and laboratory-confirmed influenza-like illness; however, the efficacy estimates were never statistically significant. The efficacies of the 100- and 200-mg/day dosages were generally similar. When data for the 100- and 200-mg/day dosage groups were combined and compared with data for the group receiving placebo, the efficacy of rimantadine in reducing the risk of clinical influenza-like illness was estimated to be 58 percent (P = 0.079). The results suggest the relative safety and clinical efficacy of using rimantadine for influenza prophylaxis among vaccinated elderly individuals and support the recommendation for a dosage reduction to 100 mg/day in this population.

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Selected References

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  • D'Alessio DJ, Cox PM, Jr, Dick EC. Failure of inactivated influenza vaccine to protect an aged population. JAMA. 1969 Oct 20;210(3):485–489. [PubMed]
  • Monto AS, Arden NH. Implications of viral resistance to amantadine in control of influenza A. Clin Infect Dis. 1992 Aug;15(2):362–369. [PubMed]
  • Arden N, Monto AS, Ohmit SE. Vaccine use and the risk of outbreaks in a sample of nursing homes during an influenza epidemic. Am J Public Health. 1995 Mar;85(3):399–401. [PMC free article] [PubMed]
  • Arden NH, Patriarca PA, Fasano MB, Lui KJ, Harmon MW, Kendal AP, Rimland D. The roles of vaccination and amantadine prophylaxis in controlling an outbreak of influenza A (H3N2) in a nursing home. Arch Intern Med. 1988 Apr;148(4):865–868. [PubMed]
  • Brady MT, Sears SD, Pacini DL, Samorodin R, DePamphilis J, Oakes M, Soo W, Clements ML. Safety and prophylactic efficacy of low-dose rimantadine in adults during an influenza A epidemic. Antimicrob Agents Chemother. 1990 Sep;34(9):1633–1636. [PMC free article] [PubMed]
  • Dolin R, Reichman RC, Madore HP, Maynard R, Linton PN, Webber-Jones J. A controlled trial of amantadine and rimantadine in the prophylaxis of influenza A infection. N Engl J Med. 1982 Sep 2;307(10):580–584. [PubMed]
  • Foster DA, Talsma A, Furumoto-Dawson A, Ohmit SE, Margulies JR, Arden NH, Monto AS. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol. 1992 Aug 1;136(3):296–307. [PubMed]
  • Hayden FG, Hay AJ. Emergence and transmission of influenza A viruses resistant to amantadine and rimantadine. Curr Top Microbiol Immunol. 1992;176:119–130. [PubMed]
  • Kent JH, Chapman LE, Schmeltz LM, Regnery HL, Cox NJ, Schonberger LB. Influenza surveillance--United States, 1991-92. MMWR CDC Surveill Summ. 1992 Sep 4;41(5):35–43. [PubMed]
  • Little JW, Hall WJ, Douglas RG, Jr, Hyde RW, Speers DM. Amantadine effect on peripheral airways abnormalities in influenza. A study in 15 students with natural influenza A infection. Ann Intern Med. 1976 Aug;85(2):177–182. [PubMed]
  • Monto AS. Influenza: quantifying morbidity and mortality. Am J Med. 1987 Jun 19;82(6A):20–25. [PubMed]
  • Monto AS, Gunn RA, Bandyk MG, King CL. Prevention of Russian influenza by amantadine. JAMA. 1979 Mar 9;241(10):1003–1007. [PubMed]
  • Murphy BR, Tierney EL, Barbour BA, Yolken RH, Alling DW, Holley HP, Jr, Mayner RE, Chanock RM. Use of the enzyme-linked immunosorbent assay to detect serum antibody responses of volunteers who received attenuated influenza A virus vaccines. Infect Immun. 1980 Aug;29(2):342–347. [PMC free article] [PubMed]
  • Nichol KL, Margolis KL, Wuorenma J, Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med. 1994 Sep 22;331(12):778–784. [PubMed]
  • Patriarca PA, Kater NA, Kendal AP, Bregman DJ, Smith JD, Sikes RK. Safety of prolonged administration of rimantadine hydrochloride in the prophylaxis of influenza A virus infections in nursing homes. Antimicrob Agents Chemother. 1984 Jul;26(1):101–103. [PMC free article] [PubMed]
  • Sabin AB. Amantadine hydrochloride. Analysis of data related to its proposed use for prevention of A2 influenza virus disease in human beings. JAMA. 1967 Jun 12;200(11):943–950. [PubMed]
  • Strassburg MA, Greenland S, Sorvillo FJ, Lieb LE, Habel LA. Influenza in the elderly: report of an outbreak and a review of vaccine effectiveness reports. Vaccine. 1986 Mar;4(1):38–44. [PubMed]
  • Tominack RL, Wills RJ, Gustavson LE, Hayden FG. Multiple-dose pharmacokinetics of rimantadine in elderly adults. Antimicrob Agents Chemother. 1988 Dec;32(12):1813–1819. [PMC free article] [PubMed]

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