Double-Dose Oseltamivir Not Beneficial in Severe Influenza
(HealthDay News) – For patients with severe influenza, double-dose oseltamivir has no benefit over standard-dose treatment, according to a study published online May 30 in BMJ.
Researchers from the South East Asia Infectious Diseases Clinical Research Network conducted a double blind randomized trial in 13 hospitals in Indonesia, Singapore, Thailand, and Vietnam involving 326 patients aged ≥1 year, including 246 children younger than 15 years, with confirmed severe influenza. The authors sought to examine the validity of recommendations to use higher than approved doses of oseltamivir. Patients were randomized to receive standard-dose oseltamivir (161 patients) or double-dose oseltamivir (165 patients).
Via reverse transcriptase polymerase chain reaction, the researchers found that on day five of treatment, similar proportions of patients were negative for influenza RNA (72.3% of double-dose recipients vs. 68.2% of standard-dose recipients; P=0.42). In subgroup analyses by virus type/subtype, age, and illness duration, there were no differences noted in clearance of virus. Mortality was similar in both groups (7.3% in double-dose vs. 5.6% in standard-dose recipients). No between-group differences were seen in the median days on supplemental oxygen, in intensive care, or on mechanical ventilation.
"There were no virological or clinical advantages with double-dose oseltamivir compared with standard-dose in patients with severe influenza admitted to hospital," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.