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Influenza Other Respir Viruses . Pharmacodynamic Effect of Different Dosage Regimes of Oseltamivir in Severe Influenza Patients Requiring Mechanical

tetano

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses


. 2025 May;19(5):e70109.
doi: 10.1111/irv.70109. Pharmacodynamic Effect of Different Dosage Regimes of Oseltamivir in Severe Influenza Patients Requiring Mechanical Ventilation: A Multicentre Randomised Controlled Trial​

Wai-Tat Wong[SUP] 1 [/SUP], Gordon Choi[SUP] 2 [/SUP], Xiansong Wang[SUP] 1 [/SUP], William Ka Kei Wu[SUP] 1 [/SUP], Ge Lin[SUP] 3 [/SUP], Martin Chi Wai Chan[SUP] 4 [/SUP], King Chung Kenny Chan[SUP] 5 [/SUP], Philip Koon Ngai Lam[SUP] 6 [/SUP], David Shu Cheong Hui[SUP] 7 [/SUP], Matthew T V Chan[SUP] 1 [/SUP]



Affiliations
Abstract

Background and objectives: This randomised controlled trial evaluated whether higher doses of oseltamivir would improve virological and clinical outcomes in severe influenza patients requiring invasive mechanical ventilation.
Methods: Forty intubated adult patients with severe influenza A or B from four intensive care units in Hong Kong were enrolled and randomised to receive either a double dose (300 mg/day) or a triple dose (450 mg/day) of oseltamivir for 10 days. Baseline data were collected, and outcomes were assessed daily using SOFA and Murray scores. Viral RNA was quantified from nasopharyngeal and tracheal aspirates. The primary outcome was the viral clearance rate after 5 days of treatment; secondary outcomes included 28-day and hospital mortality rates, changes in viral load, and serial SOFA and Murray scores.
Results: Viral clearance rates after 5 days of treatment were low and similar between the double (3/20, 15%) and triple-dose groups (2/20, 10%). No significant differences were observed in 28-day mortality, hospital mortality, ICU length of stay or duration of mechanical ventilation between the double and triple-dose groups. However, patients receiving triple doses exhibited a faster decline in influenza A viral load but had a longer hospital length of stay.
Conclusions: Triple doses of oseltamivir did not significantly improve virological or clinical outcomes compared with double doses in severe influenza.

Keywords: mechanical ventilation; oseltamivir; severe influenza.

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