Pharmacokinetics of Oral and Intravenous Oseltamivir Treatment of Severe Influenza B Virus Infection Requiring Organ Replacement Therapy

Abstract

In severe cases with multi-organ failure, administration of 100 mg intravenous oseltamivir twice-daily provided reliable drug concentrations, as opposed to renoprotective and oral dosing, thereby minimizing the risk of treatment failure and drug resistance. Evidence-based pediatric dosing recommendations and effective intravenous antiviral treatment modalities are needed for intensive care patients with life-threatening influenza disease.

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

“…The ViVI Disease Severity Score also allows consistent measurements of disease severity when following individual patients over time, as would be the case in clinical trials [40]. Follow-up assessments are useful whenever standardized severity data need to be recaptured over time.…”

“…According to the standard operating procedures, patients with a physician diagnosis of ILI and/or fulfilling predefined case criteria (body temperature ≥38°C and ≥1 respiratory symptom) admitted to the emergency department (ED) or pediatric inpatient wards, participated in the QM program [30][31][32][33][34]. Independent of routine clinical care, a specifically trained QM team obtained nasopharyngeal samples and performed standardized clinical assessments using the ViVI Disease Severity Score in line with WHO criteria for uncomplicated and complicated influenza [30,35,40].…”

“…The QM program was approved by the Institutional Review Board (EA 24/008/10). Informed consent procedures were waived for enhanced quality of care and infection control [30][31][32][33][34]40].…”

Partnering for enhanced digital surveillance of influenza‐like disease and the effect of antivirals and vaccines (PEDSIDEA)

“…The ViVI Score mobile application provides a uniform approach to defining ad hoc disease severity at any given time point, based on extensive literature review as well as WHO Criteria for uncomplicated and complicated influenza . The ViVI Score consists of nine unweighted symptoms/items reflecting uncomplicated disease (DSU1‐9) plus 13 weighted items reflecting complicated disease (DSC 1‐13) resulting in overall scores ranging from 0‐48 . Data formats and terminologies are fully compliant with Clinical Data Interchange Standards Consortium (CDISC) and regulatory requirements …”

“…Quality improvement programmes focused on optimizing treatment and prevention efforts depending on a patient's individual status will benefit from timely diagnostics and consistent use of standardized measures and operating procedures . Severity measures thus must be sufficiently granular to capture disease progression in patients with very mild to very severe disease, including within the intensive care unit …”