Comparison of High-Dose Versus Standard Dose Oseltamivir in Critically Ill Patients With Influenza

Zachary R. Noel, Melissa L.Thompson Bastin, Ashley A. Montgomery, Alexander H. Flannery

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Background: Limited data support high-dose oseltamivir in critically ill patients with influenza. In several recent influenza seasons, there were oseltamivir drug shortages. Methods: This was a retrospective cohort analysis of 57 patients admitted to the intensive care unit (ICU) with confirmed influenza. Patients receiving high-dose oseltamivir were compared to those receiving standard dosing. Results: When adjusted for clinically relevant predictors of disease severity, including age, duration of therapy, Acute Physiology and Chronic Health Evaluation II score, and receipt of extracorporeal membrane oxygenation, there was no difference in the duration of mechanical ventilation, oxygenation, ICU length of stay, or hospital length of stay between the high-dose and standard dose groups. Conclusions: As compared to the standard doses of oseltamivir, higher-dose (ie, double dose) oseltamivir was not associated with improvement in any clinical outcomes. Using higher doses empirically on all patients during influenza season may exacerbate local drug shortages.

Original languageEnglish
Pages (from-to)574-577
Number of pages4
JournalJournal of Intensive Care Medicine
Issue number10
StatePublished - Dec 1 2017

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project described was supported by the National Center for Research Resources, the National Center for Advancing Translational Sciences, and National Institutes of Health, through Grant 8UL1TR000117-02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Publisher Copyright:
© 2016, © The Author(s) 2016.


  • critical care
  • dosage
  • influenza
  • intensive care
  • oseltamivir

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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