This Scottish Health Protection Network (SHPN) guide should be used alongside the external guidance that it relates to.
This guide covers the UKHSA 'Guidance on the use of antiviral agents for the treatment and prophylaxis of seasonal influenza'.
This external guidance has been approved for use in Scotland by the SHPN Guidance Group (SHPN-GG).
This guidance is for health protection professionals only.
Other people who require advice should contact their local health protection team.
What the guidance covers
This guidance covers:
- treatment of suspected or confirmed influenza
- post-exposure prophylaxis supply of zanamivir aqueous solution
- use of anti-virals in pregnancy, breastfeeding, hepatic or renal dysfunction
Guide for use in Scotland
The following recommendations for using this guidance in Scotland were agreed by the SHPN through the agreed review and adoption process.
For UK Health Security Agency (UKHSA) read Public Health Scotland (PHS).
There are slight differences in the contractual arrangements for prescribing antivirals in primary care.
The text 'Prescribing in primary care' and 'Prescribing in secondary care' on page 31 does not apply in Scotland.
The Scottish position is as follows.
Prescribing in primary care
NICE guidance, approved for use in Scotland by NHS HIS, is relevant to all clinicians (primary and secondary care).
Part 12 (drugs to be prescribed under certain circumstances in NHS pharmaceutical services) of Scottish Drug Tariff, restricts GPs to only prescribe antiviral medicines to specified people who are listed in the Drug Tariff (clinical priority and risk groups).
GPs have the discretion to prescribe antiviral medicines for people who may not be in the specified at-risk groups but who they believe would suffer serious complications if not treated with an antiviral medicine.
Prescribing in secondary care
Clinicians in secondary care are not subject to the Scottish Drug Tariff restrictions, so can use their clinical judgement to prescribe antiviral medicines, including for those not in the at-risk groups.
Paragraph 2 in the introduction on page 5 should be replaced with:
This guidance should be used in secondary care for any patient where influenza is suspected or confirmed at any time.
In primary care contractually the guidance should only be considered once the Scottish Government (SG) issues notice that influenza is circulating and that antiviral agents can be used.
However, antivirals may be used in primary care out with the periods when national surveillance indicates that influenza virus is circulating in the community in certain situations.
For example, during localised outbreaks of influenza-like illness for the treatment of influenza in people who live in longterm residential or nursing homes.
View the external guidelines
When using this guidance, remember to check whether the recommendations for use in Scotland provided by SHPN have been updated.