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Intensive Care Medicine

, Volume 39, Issue 5, pp 977–978 | Cite as

Pharmacokinetics of oseltamivir carboxylate in critically ill patients: each patient is unique

  • W. KromdijkEmail author
  • M. A. Sikma
  • M. P. H. van den Broek
  • J. H. Beijnen
  • A. D. R. Huitema
  • D. W. de Lange
Correspondence

Dear Editor,

Patients infected with the 2009 H1N1 pandemic influenza virus often develop severe viral pneumonia with acute respiratory distress syndrome (ARDS) and multiple organ failure. High-dose oseltamivir (≥150 mg twice daily) has been advocated as optimal treatment [1]. However, the scientific evidence for this advice is lacking thus far [2]. Therefore, we explored the pharmacokinetics of oseltamivir and its active metabolite oseltamivir carboxylate in critically ill patients with H1N1 pandemic influenza following different dosing regimens.

All patients with H1N1 pandemic influenza admitted to the ICU of the University Medical Center Utrecht were eligible for inclusion. Patients received oseltamivir at a dose determined by their treating physician, and blood samples were drawn at t = 0, 1, 2, 3, 4 and 8 h on day three of treatment. Oseltamivir and oseltamivir carboxylate plasma concentrations were determined by HPLC–MS/MS [3]. The area under the concentration–time curve from 0...

Keywords

Acute Respiratory Distress Syndrome Aspergillosis Oseltamivir Extracorporeal Membrane Oxygenation Hairy Cell Leukemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

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    WHO (2009) Guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. Available at: http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/index.html. Accessed 29 January 2013
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    Ariano RE, Sitar DS, Zelenitsky SA, Zarychanski R, Pisipati A, Ahern S, Kanji S, Rello J, Kumar A (2010) Enteric absorption and pharmacokinetics of oseltamivir in critically ill patients with pandemic (H1N1) influenza. CMAJ 182(4):357–363PubMedCrossRefGoogle Scholar
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    Kromdijk W, Rosing H, van den Broek MP, Beijnen JH, Huitema AD (2012) Quantitative determination of oseltamivir and oseltamivir carboxylate in human fluoride EDTA plasma including the ex vivo stability using high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 891–892:57–63PubMedGoogle Scholar
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    Anderson GD (2005) Pregnancy-induced changes in pharmacokinetics: a mechanistic-based approach. Clin Pharmacokinet 44(10):989–1008PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2013

Authors and Affiliations

  • W. Kromdijk
    • 1
    Email author
  • M. A. Sikma
    • 2
  • M. P. H. van den Broek
    • 3
  • J. H. Beijnen
    • 1
    • 4
  • A. D. R. Huitema
    • 1
  • D. W. de Lange
    • 2
  1. 1.Department of Pharmacy & PharmacologySlotervaart HospitalAmsterdamThe Netherlands
  2. 2.Intensive Care Center and Dutch Poison Information CenterUniversity Medical CenterUtrechtThe Netherlands
  3. 3.Department of Clinical PharmacyUniversity Medical CenterUtrechtThe Netherlands
  4. 4.Faculty of Science, Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical PharmacologyUtrecht UniversityUtrechtThe Netherlands

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