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Table 3 Prophylaxis regimen for healthcare worker after needle stick injury

From: Human Ebola virus infection in West Africa: a review of available therapeutic agents that target different steps of the life cycle of Ebola virus

Regimen

Oral1

Intravenous4

Central venous line

Not required

Required

Interferon-beta

6 million international units (MIU) prefilled pen via intramuscular injection (IMI) weekly for 3 weeks.2

6 MIU intravenous infusion over 2 hour daily for up to 3 weeks3 or 6 MIU prefilled pen IMI weekly for 3 weeks.

Amiodarone

600 mg p.o. twice daily for 8 days (loading) then maintenance 600 mg p.o. daily for further 3 weeks.

150 mg into 100 ml D5 over 10 minutes followed by 360 mg infusion over 6 hours then 540 mg infusion over 18 hours D1.4 Amiodarone 720 mg infusion daily or 600 mg p.o. twice daily for further 7 days followed by 600 mg p.o. maintenance daily for further 3 weeks.

Toremifene

800 mg p.o. on Day 1 (loading) then 400 mg p.o. daily.5

800 mg p.o. on Day 1 (loading) then 400 mg p.o. daily.5

Favipiravir

1800 mg p.o. twice daily on Day 1 (loading doses) then 800 mg p.o. twice daily.6

1800 mg p.o. twice daily on Day 1 (loading doses) then 800 mg p.o. twice daily.

  1. 1Oral regimen are for those workers who are already on amiodarone prophylaxis with a loading dose of amiodarone 600 mg p.o. twice daily for 8 days followed by maintenance amiodarone 600 mg p.o. daily. Electrocardiogram and thyroid function should be monitored.
  2. 2Monitor for side effect of thrombocytopenia and proteinuria.
  3. 3Intravenous dosage of IFN-β that are used for human hepatitis C virus infection to induce IFITM1 to limit viral entry.
  4. 4Intravenous regimen is for those workers who have not been on amiodarone prophylaxis and agreed for the insertion of a central venous line for drug administration. Intravenous amiodarone should be administered via central venous line to avoid phlebitis. The dosage for treatment of frequently recurring ventricular fibrillation and hemodynamically unstable ventricular tachycardia is recommended because it can achieve therapeutic drug level immediately after the first dose of amiodarone.
  5. 5http://www.pulmcrit.org/2014/08/could-estrogen-receptor-antagonists.html.
  6. 6Dosage for the treatment of human influenza virus infection in human Phase 3 trial of Favipiravir (FAVOR Study). http://www.clinicaltrials.gov/show/NCT02008344.
  7. The recommended dosage for treatment of human EBOV infection may be 2 to 5 times higher than influenza studies. Please confirm the recommended dose with the drug company.