ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2010
Enteric absorption and pharmacokinetics of oseltamivir in critically ill patients with pandemic (H1N1) influenza.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Alternative Regimens of Neuraminidase Inhibitors for Therapy of Hospitalized Adults with Influenza: A Systematic Review of Randomized Controlled Trials.Advances in therapy · 2020Pooled it
- JAID/JSC Guidelines for the Treatment of Respiratory Infectious Diseases: The Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy - The JAID/JSC Guide to Clinical Management of Infectious Disease/Guideline-preparing Committee Respiratory Infectious Disease WG.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2016Guideline
- Pharmacodynamic Effect of Different Dosage Regimes of Oseltamivir in Severe Influenza Patients Requiring Mechanical Ventilation: A Multicentre Randomised Controlled Trial.Influenza and other respiratory viruses · 2025Trial
- A part-randomized study of intravenous oseltamivir in adolescents and adults.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Trial
- Pharmacokinetics of orally administered oseltamivir in healthy obese and nonobese Thai subjects.Antimicrobial agents and chemotherapy · 2014Trial
- Safety, tolerability, and pharmacokinetics of intravenous oseltamivir: single- and multiple-dose phase I studies with healthy volunteers.Antimicrobial agents and chemotherapy · 2012Trial
- Oseltamivir and oseltamivir carboxylate pharmacokinetics in obese adults: dose modification for weight is not necessary.Antimicrobial agents and chemotherapy · 2011Trial
- Antiviral Drugs in Influenza.International journal of environmental research and public health · 2022Review
- Substitution of I222L-E119V in neuraminidase from highly pathogenic avian influenza H7N9 virus exhibited synergistic resistance effect to oseltamivir in mice.Scientific reports · 2021Article
- Antiviral treatment strategy should be individualized in critically ill patients with severe influenza.Intensive care medicine · 2020Article
- Severe flu management: a point of view.Intensive care medicine · 2020Review
- Clinical Effectiveness of Intravenous Peramivir versus Oseltamivir for the Treatment of Influenza in Hospitalized Patients.Infection and drug resistance · 2020Article
- Paracetamol absorption test to detect poor enteric absorption of oseltamivir in intensive care unit patients with severe influenza: a pilot study.Intensive care medicine · 2019Article
- Influenza Infections and Emergent Viral Infections in Intensive Care Unit.Seminars in respiratory and critical care medicine · 2019Review
- Influenza virus-related critical illness: prevention, diagnosis, treatment.Critical care (London, England) · 2019Review
- Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Characteristics and mortality of severe influenza cases treated with parenteral aqueous zanamivir, United Kingdom, October 2009 to January 2011.Influenza and other respiratory viruses · 2019Observational
- Impact of Obesity on Influenza A Virus Pathogenesis, Immune Response, and Evolution.Frontiers in immunology · 2019Review
- Contemporary management of severe influenza disease in the intensive care unit.Journal of critical care · 2018Review
- Zika virus like particles elicit protective antibodies in mice.PLoS neglected tropical diseases · 2018Article
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Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether the enteric absorption of the neuraminidase inhibitor oseltamivir is impaired in critically ill patients is unknown. We documented the pharmacokinetic profile of oseltamivir in patients admitted to intensive care units (ICUs) with suspected or confirmed pandemic (H1N1) influenza.
methodsWe included 41 patients 18 years of age and older with suspected or confirmed pandemic (H1N1) influenza who were admitted for ventilatory support to nine ICUs in three cities in Canada and Spain. Using tandem mass spectrometry, we assessed plasma levels of oseltamivir free base and its active metabolite carboxylate at baseline (before gastric administration of the drug) and at 2, 4, 6, 9 and 12 hours after the fourth or later dose.
resultsAmong the 36 patients who did not require dialysis, the median concentration of oseltamivir free base was 10.4 (interquartile range [IQR] 4.8-14.9) microg/L; the median concentration of the carboxylate metabolite was 404 (IQR 257-900) microg/L. The volume of distribution of the carboxylate metabolite did not increase with increasing body weight (R2=0.00, p=0.87). The rate of elimination of oseltamivir carboxylate was modestly correlated with estimations of creatinine clearance (R2=0.27, p<0.001). Drug clearance in the five patients who required continuous renal replacement therapy was about one-sixth that in the 36 patients with relatively normal renal function.
interpretationOseltamivir was well absorbed enterically in critically ill patients admitted to the ICU with suspected or confirmed pandemic (H1N1) influenza. The dosage of 75 mg twice daily achieved plasma levels that were comparable to those in ambulatory patients and were far in excess of concentrations required to maximally inhibit neuraminidase activity of the virus. Adjustment of the dosage in patients with renal dysfunction requiring continuous renal replacement therapy is appropriate; adjustment for obesity does not appear to be necessary.
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