The National Institute for Health and Clinical Excellence (NICE) has published a technology appraisal offering guidance on the use of oseltamivir, amantadine and zanamivir for the prophylaxis of influenza.

The guidelines recommend oseltamivir and zanamivir to prevent flu if all of the following apply:
• The amount of flu virus going around is enough that if someone has a flu-like illness it is likely that it has been caused by the flu virus
• The person is in an at-risk group
• The person has been in contact with someone with a flu-like illness and can start treatment within 36 hours (for zanamivir) or within 48 hours (for oseltamivir)
• The person has not been effectively protected by vaccination

The guidance does not cover widespread epidemics and national guidelines to promote flu vaccination in vulnerable patient groups are still recommended. Amantadine is not recommended for the prophylaxis of influenza.