BACKGROUND: One key component of human rabies prevention is the use of postexposure prophylaxis (PEP). No information is routinely available to evaluate the appropriateness of this intervention. METHODS: A survey queried county health departments regarding rabies PEP administered during July through September in 1997 and in 1998. RESULTS: A total of 160 cases meeting the study criteria were characterized. Domestic animals accounted for most potential rabies exposures. Nearly a quarter of the reports indicated that PEP was not necessary. Health departments collected just over 25% of costs for antirabies biologics. CONCLUSIONS: Human rabies prevention systems can be enhanced by reducing the number of PEP events through improved recovery of biting animals. Inappropriate administration of PEP and cost can be reduced by establishing a system of after-the-fact review of every episode of PEP with timely feedback to providers.
BACKGROUND: One key component of human rabies prevention is the use of postexposure prophylaxis (PEP). No information is routinely available to evaluate the appropriateness of this intervention. METHODS: A survey queried county health departments regarding rabies PEP administered during July through September in 1997 and in 1998. RESULTS: A total of 160 cases meeting the study criteria were characterized. Domestic animals accounted for most potential rabies exposures. Nearly a quarter of the reports indicated that PEP was not necessary. Health departments collected just over 25% of costs for antirabies biologics. CONCLUSIONS:Human rabies prevention systems can be enhanced by reducing the number of PEP events through improved recovery of biting animals. Inappropriate administration of PEP and cost can be reduced by establishing a system of after-the-fact review of every episode of PEP with timely feedback to providers.