MMS Flu Advisory: DPH Issues Orders for Antiviral Prescribing and Guidance for Clinicians and Institutions

The state Department of Public Health (DPH) has issued orders allowing pharmacists to compound oral suspension of oseltamivir onsite (a non-sterile procedure) in light of a shortage. Such compounding does not require consultation with the prescriber where the prescription does not specifically authorize compounding.

DPH advises physicians prescribing oseltamivir oral suspension to prescribe medication in mg (milligrams) rather than ML or tsp, and include the statement, “May substitute compounded suspension” although this statement is not required for pharmacists to compound the suspension. Oseltamivir oral suspension is especially important to treat pediatric patients and certain adults with difficulty swallowing oral dosage forms. The orders, and guidance for prescribers and pharmacists, regarding oseltamivir oral suspension are available here.

The DPH has also issued separate guidance, effective today for acute care hospitals and emergency rooms, long term care facilities and EMS personnel to help manage the large influx of patients with influenza like illness (ILI).

DPH provided recommendations to acute care hospitals and emergency rooms regarding (1) Reducing or eliminating the need for boarding patients in the emergency department, and (2) Authorization and guidelines for use of alternate space for treatment of ambulatory patients presenting with Influenza-like Illness (ILI).

DPH also advises long term care facilities that a diagnosis of influenza is not a valid reason for denial of admission to a long term care facility. The advice includes 2012-13 Influenza and Pneumococcal Disease Control Recommendations.

The policy for EMS personnel addresses dispatch/triage, field treatment and transport, and post-transport guidance.

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