Background Controversy exists over the efficacy of oseltamivir; even the FDA and CDC disagree. We reviewed the available evidence on the efficacy of oseltamivir in both paediatric and adult populations. It was concluded that there is no justification for the use of oseltamivir in conditions other than those authorised: there is no statistically significant difference in efficacy between standard dose and double dose; neither are there studies specifically designed to evaluate the efficacy of oseltamivir beyond 5 days of treatment.
Purpose To evaluate the suitability of oseltamivir prescription according to the evidence available in hospitalised patients.
Material and methods An observational retrospective study performed from 1 October 2014 to 30 April 2015 in a general hospital. It included paediatric and adult patients treated with oseltamivir during that period. Patients were identified through a computerised prescription order entry system (PrescriWin). We reviewed the medical records and registred age, gender, clinical service, posology, duration of treatment and estimated glomerular filtration rate (eGFR) using the MDRD-4 IDMS. We reviewed discharge reports in those patients who were discharged before the end of therapy with oseltamivir. All data were reviewed and evaluated for their suitability according to the available evidence.
Results 47 patients were treated with oseltamivir during the study period, 1 being excluded because it was not possible to gather the necessary information for the study. 37% were male and the average age was 68 years. 34 patients (74%) received oseltamivir according to the technical specifications of the European Medicines Agency (EMA). However, 15 discrepancies were found in 12 patients (26%). 2 patients (4%) received double dose therapy (150 mg/12 h) and 7 patients (15%) received oseltamivir for more than 5 days (only 2 of them were hospitalised in the ICU). In 8 cases, the eGFR was <60 mL/min, and in only 2 patients (25%) was the dose adjusted according to the EMA.
Conclusion The results of our study confirm that there was a large variation in oseltamivir prescription. A high percentage of patients received a regimen outside of the labelled recommendations.
References and/or Acknowledgements
McQuade B, Blair M. Influenza treatment with oseltamivir outside of labeled recommendations. Am J Health Syst Pharm 2015;134-8
References and/or AcknowledgementsNo conflict of interest.
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