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

doi:10.1177/0885066616638649

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 journal › Review article › peer-review

18 Scopus citations

Abstract

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 language	English
Pages (from-to)	574-577
Number of pages	4
Journal	Journal of Intensive Care Medicine
Volume	32
Issue number	10
DOIs	https://doi.org/10.1177/0885066616638649
State	Published - Dec 1 2017

Bibliographical note

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

Funding

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.

Funders	Funder number
National Institutes of Health (NIH)	8UL1TR000117-02
National Center for Research Resources
National Center for Advancing Translational Sciences (NCATS)

Keywords

critical care
dosage
influenza
intensive care
oseltamivir

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

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10.1177/0885066616638649

Cite this

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title = "Comparison of High-Dose Versus Standard Dose Oseltamivir in Critically Ill Patients With Influenza",

abstract = "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.",

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author = "Noel, \{Zachary R.\} and Bastin, \{Melissa L.Thompson\} and Montgomery, \{Ashley A.\} and Flannery, \{Alexander H.\}",

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doi = "10.1177/0885066616638649",

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AU - Noel, Zachary R.

AU - Bastin, Melissa L.Thompson

AU - Montgomery, Ashley A.

AU - Flannery, Alexander H.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - 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.

AB - 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.

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

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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