American Board of Internal Medicine (ABIM) Certification Practice Exam

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How soon after exposure to influenza should chemoprophylaxis with neuraminidase inhibitors be initiated?

  1. 24 hours

  2. 36 hours

  3. 48 hours

  4. 72 hours

The correct answer is: 48 hours

Initiating chemoprophylaxis with neuraminidase inhibitors after exposure to influenza is most effective when done within a timely manner, specifically within 48 hours. Although starting within 24 hours is optimal for treatment in symptomatic patients, for prophylaxis following an exposure, the window extends slightly. Starting chemotherapy within 48 hours of exposure provides individuals with the best chance of preventing the onset of influenza, as these medications work best in this time frame to inhibit the virus's ability to replicate and spread within the body. If chemoprophylaxis is administered after this 48-hour window, its effectiveness significantly decreases, primarily due to the viral replication that has already occurred. Thus, initiating chemoprophylaxis within this time frame is crucial for optimal prevention.