Triple oseltamivir dose resulted in rapid clearance of H1N1

Issue: October 2013

DENVER — Treatment with a triple dose of oseltamivir resulted in more rapid viral clearance in patients with severe pandemic (H1N1) influenza A, according to research presented here at the 2013 Interscience Conference on Antimicrobial Agents and Chemotherapy.

“This is important because rapid viral clearance is often related to survival, and the duration of isolation is related to how long the virus is in your system,” Anand Kumar, MD, associate professor of medical microbiology at the University of Manitoba, said during a press conference.

From October 2009 to May 2011, Kumar and colleagues conducted a randomized, controlled, double-blind study of patients with suspected severe influenza who were admitted to the ICU. Eligible patients were randomly assigned to a standard 75 mg twice-daily dose of oseltamivir (Tamiflu, Genentech) or a triple dose, 225 mg twice-daily. On the fifth day of therapy, viral clearance was measured.

The study included 18 patients who had laboratory-confirmed H1N1 influenza. Of the nine patients who were treated with the triple-dose therapy seven were negative for the virus at day 5. Among the patients who received the standard dose therapy, only one patient cleared the virus by day 5. The high-dose treatment was also well-tolerated, and there were no differences between the groups in 30-day survival, ICU and hospital survival and in mechanical ventilation when needed.

“The effect of triple-dose therapy is important because with certain other influenza viruses, including H7N9 which is circulating in China and has potential to cause a new pandemic, double- or triple-dose therapy is often used,” Kumar said.

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Disclosure: Kumar has a research relationship with Roche Pharmaceuticals.