What is the protocol for employee post-exposure prophylaxis (PEP) for common illnesses?

From the Guidelines

To draft an employee post-exposure prophylaxis (PEP) policy for common illnesses, focus on creating comprehensive protocols for bloodborne pathogens, tuberculosis, meningitis, pertussis, influenza, and COVID-19, prioritizing the most recent and highest quality evidence available, such as the guidelines from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) 1. When developing the policy, consider the following key points:

• For HIV exposure, initiate PEP within 72 hours using a three-drug regimen such as Truvada (tenofovir/emtricitabine) plus dolutegravir for 28 days, with baseline and follow-up testing, as recommended by the CDC 1.
• For Hepatitis B, unvaccinated staff should receive HBIG and begin the vaccine series; for Hepatitis C, baseline testing and monitoring are essential as no PEP exists, according to the guidelines from the CDC and the WHO 1.
• TB exposure requires baseline testing with either TST or IGRA, followed by repeat testing 8-10 weeks post-exposure, with latent TB treatment using isoniazid 300mg daily for 9 months or rifampin 600mg daily for 4 months if converted, as recommended by the CDC and the WHO 1.
• For meningococcal exposure, ciprofloxacin 500mg as a single dose or rifampin 600mg twice daily for 2 days is recommended, according to the guidelines from the CDC and the WHO 1.
• Pertussis exposure requires azithromycin 500mg on day 1 followed by 250mg daily for 4 more days, as recommended by the CDC and the WHO 1.
• Seasonal influenza exposure may warrant oseltamivir 75mg twice daily for 5-7 days for high-risk staff, according to the guidelines from the CDC and the WHO 1. The policy should clearly define exposure criteria, reporting procedures, confidentiality measures, and follow-up protocols, with designated occupational health staff to coordinate PEP administration and documentation of all exposures and interventions, as emphasized by the CDC and the WHO 1.

From the FDA Drug Label

Initiate post-exposure prophylaxis with oseltamivir phosphate for oral suspension within 48 hours following close contact with an infected individual. The recommended dosage of oseltamivir phosphate for oral suspension for prophylaxis of influenza in adults and adolescents 13 years and older is 75 mg orally once daily (12. 5 mL of oral suspension once daily) for at least 10 days following close contact with an infected individual and up to 6 weeks during a community outbreak.

• Post-exposure prophylaxis for influenza with oseltamivir phosphate for oral suspension should be initiated within 48 hours of close contact with an infected individual.
• The recommended dosage for adults and adolescents (13 years and older) is 75 mg orally once daily for at least 10 days following close contact with an infected individual and up to 6 weeks during a community outbreak 2.

From the Research

Post Exposure Prophylaxis Policy

To draft an employee staff post exposure prophylaxis policy for common illnesses, consider the following key points:

• Timely postexposure prophylaxis is crucial after an occupational exposure to prevent the transmission of infectious diseases 3.
• Healthcare personnel are at risk of exposure to various pathogens, including bloodborne pathogens like HIV, Hepatitis B, and Hepatitis C, through needlestick injuries or other routes of transmission 3, 4, 5.
• The policy should include guidelines for the management of exposures, including the notification of infection control and occupational health departments, identification of contacts, and application of immediate infection control measures 4.
• Postexposure prophylaxis regimens should be based on the type of exposure and the pathogen involved, and should be administered promptly to minimize the risk of transmission 3, 5.
• The policy should also consider the use of vaccines and therapeutics to prevent and treat infectious diseases, and should be updated regularly to reflect new evidence and guidelines 3.

Common Illnesses and Postexposure Prophylaxis

Some common illnesses that may require postexposure prophylaxis include:

• HIV: antiretroviral therapy, such as emtricitabine + rilpivirine + tenofovir alafenamide, may be used for postexposure prophylaxis 6.
• Hepatitis B: vaccination and/or hepatitis B immune globulin may be used for postexposure prophylaxis.
• Hepatitis C: no vaccine is available, but antiviral therapy may be used for treatment.
• Other infectious diseases, such as pertussis, invasive meningococcus infections, and tuberculosis, may also require postexposure prophylaxis 5.

Implementation and Monitoring

The policy should be implemented and monitored to ensure that:

• All employees are aware of the policy and procedures for reporting exposures and receiving postexposure prophylaxis.
• Exposures are reported promptly and managed according to the policy.
• Postexposure prophylaxis is administered promptly and effectively.
• The policy is reviewed and updated regularly to reflect new evidence and guidelines.