Annual vaccination against influenza A and B viruses is the most effective method of preventing influenza. An upcoming issue of The Medical Letter will review drugs for chemoprophylaxis and treatment of influenza.

A 23-valent polysaccharide vaccine (PPSV23; Pneumovax 23 - Merck) is the only pneumococcal vaccine approved for use in adults. It has reduced the risk of invasive pneumococcal disease (meningitis or bacteremic pneumonia), but not mortality, in immunocompetent older adults.2 PPSV23 has not been shown to reduce the risk of invasive pneumococcal disease (IPD) in immunocompromised patients.

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The FDA has licensed Adacel (Aventis Pasteur) and Boostrix (GlaxoSmithKline), two new combination vaccines that include tetanus toxoid, diphtheria toxoid and acellular pertussis antigens (Tdap), for use as a booster in adolescents and adults. In the past, older children and adults were not re-immunized against pertussis because of concerns about reactions to the whole-cell vaccine previously used in younger children. The CDC Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) have recommended that either of the new Tdap vaccines replace routine tetanus-diphtheria (Td) boosters in adolescents 11-18 years old, and Adacel should replace Td boosters in adults 19-64 years old.

Antiviral prophylaxis is indicated for influenza exposures that occur before (or less than 2 weeks after) vaccination with inactivated vaccine, or in years when circulating strains differ from those included in the vaccine. Antiviral drugs can also be used for treatment of patients who develop symptoms of influenza, regardless of vaccination status.
Please see Update: Influenza Resistance to Amantadine and Rimantadine