Effectiveness of double-dose oseltamivir for pediatric patients with severe 2009 pandemic influenza A H1N1

Hyun Seok Cho; Se Ra Min; Joon Ho Lee; Sung Yeun Ahn; Hyeon Soo Lee; Jeong Hee Yang; Ja Kyoung Kim

doi:10.4168/aard.2014.2.1.64

Journal List > Allergy Asthma Respir Dis > v.2(1) > 1059069

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Cho, Min, Lee, Ahn, Lee, Yang, and Kim: Effectiveness of double-dose oseltamivir for pediatric patients with severe 2009 pandemic influenza A H1N1

Original Article

Allergy, Asthma & Respiratory Disease 2014; 2(1): 64-69.

Published online: 31 March 2014

DOI: https://doi.org/10.4168/aard.2014.2.1.64

Effectiveness of double-dose oseltamivir for pediatric patients with severe 2009 pandemic influenza A H1N1

Hyun Seok Cho¹, Se Ra Min¹, Joon Ho Lee¹, Sung Yeun Ahn¹, Hyeon Soo Lee¹, Jeong Hee Yang², Ja Kyoung Kim¹

¹Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea.

²Department of Family Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.

Correspondence to: Ja Kyoung Kim. Department of Pediatrics, Kangwon National University Hospital, Kangwon National University School of Medicine, 156 Baengnyeong-ro, Chuncheon 200-722, Korea. Tel: +82-33-258-2181, Fax: +82-33-258-2418, kjaky@kangwon.ac.kr

Received 2 August 2013 Revised 15 October 2013 Accepted 24 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

We aimed to evaluate the use and safety of double dose oseltamivir for patients manifesting severe respiratory symptoms or showing no improvement of clinical symptoms after 72 hours' treatment with the usual oseltamivir dosage.

Methods

We analyzed the clinical features of 2009 influenza A H1N1 inpatients who had been admitted to a university hospital's Department of Pediatrics between August 2009 and January 2010. The Influenza A H1N1 diagnoses were confirmed by real-time reverse transcriptase polymerase chain reaction.

Results

The study participants numbered 157 (mean age, 5.0 years; male-to-female ratio, 1.1:1). Among them, twenty (mean age, 5.2 years) were administered double dose oseltamivir. This double dose group showed higher peak body temperatures and more abnormal radiologic results than the other, usual-dose group. The mean time duration between high fever and afebrile status after initiation of double-dose oseltamivir administration was 2.1 days, whereas that within the usual-dose group was 1.7 days. There were no adverse effects in the patients treated with double-dose oseltamivir.

Conclusion

Double-dose oseltamivir was well tolerated in patients with severe 2009 influenza A H1N1 infection.

Keywords: Influenza A virus, H1N1 subtype, Pediatrics, Severity of illness index, Oseltamivir

Figures and Tables

Table 1

Baseline characteristics of patients hospitalized with Influenza A H1N1 (n=157)

Values are presented as mean (range), number (%), or mean±standard deviation.

VSD, ventricular septal defect; GI, gastrointestinal.

^*There was a statistical significance in the severe-symptoms group, as tested by one-way analysis of variance.

Table 2

Clinical features and radiologic and laboratory test results for Influenza A H1N1 patients receiving double-dose oseltamivir (n=20)

Values are presented as mean (range).

GI, gastrointestinal; WBC, white blood cell; CRP, C-reactive protein.

^*Other symptoms included arthralgia, skin lesion, and headache. The first patient complained of arthralgia and urticaria on the day of admittance; the second patient complained of macular rash, abdominal pain and the uttering of meaningless words, immediately upon taking the first double-dose of oseltamivir; the third patient complained of headache.

Table 3

Treatments and outcomes for 20 Influenza A H1N1 patients receiving double-dose oseltamivir

Values are presented as mean (range).

ICU, intensive care unit.

^*The antibiotics amoxicillin-clavulate and third generation cephalosporin were administered to all of the patients. ^†The other medications were steroids and aminophylline. ^‡This patient was administered steroids.

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