{"id":30600,"date":"2026-06-22T04:28:00","date_gmt":"2026-06-21T20:28:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30600"},"modified":"2026-06-22T05:43:19","modified_gmt":"2026-06-21T21:43:19","slug":"jama-intern-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8a%a4%e7%90%86%e9%99%a2%e6%b5%81%e6%84%9f%e7%88%86%e5%8f%91%e6%97%b6%e7%ab%8b%e5%8d%b3%e8%bf%9b%e8%a1%8c%e5%bc%ba%e5%8c%96%e6%8a%97","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30600","title":{"rendered":"[JAMA Intern Med\u53d1\u8868\u8bba\u6587]\uff1a\u62a4\u7406\u9662\u6d41\u611f\u7206\u53d1\u65f6\u7acb\u5373\u8fdb\u884c\u5f3a\u5316\u6297\u75c5\u6bd2\u836f\u7269\u9884\u9632"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Aging and Health<\/p>\n\n\n\n

Prompt and Intensive Antiviral Chemoprophylaxis in Nursing Home Influenza Outbreaks<\/h1>\n\n\n\n

Joe B. B. Silva, Han-Chih T. Hsieh, Chanelle J. Howe, et al<\/h3>\n\n\n\n

JAMA Intern Med Published Online: March 30, 2026<\/h3>\n\n\n\n

doi: 10.1001\/jamainternmed.2026.0401<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Is initiation of antiviral chemoprophylaxis with oseltamivir for 70% or more of eligible nursing home (NH) residents within 2 days of outbreak detection associated with lower 14-day and 30-day mortality and hospitalization compared with a nonintensive approach?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study of 404 influenza outbreaks across 318 NHs with 35 086 resident-trial observations using a sequential target trial emulation and the randomize-censor-weight approach, hospitalization but not death was lower at 14 days post outbreak in NHs that implemented intensive antiviral chemoprophylaxis; 30-day estimates were directionally similar but less precise.<\/p>\n\n\n\n

Meaning<\/strong>  Results of this study suggest that clinicians should promptly initiate antiviral chemoprophylaxis in at least 70% of NH residents within 2 days of an influenza outbreak to markedly reduce influenza-related hospitalizations.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Influenza outbreaks in nursing homes (NHs) can cause high morbidity and mortality. Antiviral chemoprophylaxis with oseltamivir is recommended, yet optimal implementation strategies remain unclear.<\/p>\n\n\n\n

Objective<\/strong>  To examine whether initiating antiviral chemoprophylaxis for 70% or more of eligible NH residents within 2 days of influenza outbreak detection is associated with lower all-cause mortality and hospitalization at 14 and 30 days.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Retrospective cohort study using a sequential cluster-randomized target trial emulation and randomize-censor-weight approach for influenza outbreaks (September 1, 2018\u2013May 31, 2022) in 12 US NH corporations. Eligibility criteria were age 18 years or older, present on the outbreak-detection day, no antiviral use in the preceding 7 days, no influenza in the past 14 days, and complete baseline data. Residents were followed up until hospitalization or death, an NH discharge to a nonacute-care location, or the end of follow-up. Data were analyzed from February 2023 to January 2026.<\/p>\n\n\n\n

Exposures<\/strong>  Intensive antiviral chemoprophylaxis with oseltamivir (\u226570% of eligible residents within 2 days of outbreak detection) or nonintensive antiviral chemoprophylaxis (0% to <70% of eligible residents).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Outcomes were all-cause death and hospitalizations within 14 and 30 days of outbreak detection. Discrete-time hazard models with pooled logistic regression were applied to estimate weighted risks, risk differences (RDs), and risk ratios (RRs).<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among 404 outbreaks in 318 NHs, 35\u202f086 resident-trial observations (29\u202f683 residents; median age 78 [IQR, 68- 86] years; 60% women; 81% White; 76% vaccinated) met eligibility criteria. Intensive oseltamivir prophylaxis was randomized to 17\u202f155 observations; 17\u202f931 were randomized to nonintensive care. At 14 days, intensive prophylaxis vs nonintensive yielded an RD of \u20130.06% (95% CI, \u22120.73% to 0.93%) and an RR of 0.96 (95% CI, 0.56-1.57) for death, and an RD of \u20130.96% (95% CI, \u22121.78% to \u22120.19%) and an RR of 0.79 (95% CI, 0.64-0.96) for hospitalization. At 30 days, the hospitalization differences persisted but were less precise and there continued to be no difference in death.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Study results suggest that clinicians should initiate antiviral chemoprophylaxis for at least 70% of eligible NH residents within 2 days of outbreak detection to lower risk of hospitalization.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Aging and Health Prompt an […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30600"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30600"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30600\/revisions"}],"predecessor-version":[{"id":31056,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30600\/revisions\/31056"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30600"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30600"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30600"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}