Should We Calculate CrCl in Advance for All Our Patients in Our Nursing Homes to Prepare for Flu Season?

Tamiflu is widely used for prophylaxis for influenza in long term care (LTC). Prophylaxis for all residents in LTC experiencing an outbreak regardless of vaccination status is recommended by the CDC. Creatinine Clearance (CrCl) is preferred for Tamiflu dosing rather than GFR; however, CrCl is not automatically calculated on Basic Metabolic Panel (BMP). Tamiflu is often dosed based on Glomerular Filtration Rate (GFR), a calculation that actually underestimates renal function, putting patients at risk for subtherapeutic doses when used.