Route of Oseltamivir Administration Affects Metabolite Concentrations in Critically Ill Children

Abstract

We performed a prospective cohort study to investigate oseltamivir administration in critically ill children. We found that enteric tube administration of oseltamivir resulted in lower concentrations of its active metabolite compared with oral delivery. These findings could have significant clinical implications, and more studies are required to better understand the effects of administration route on potential lower systemic metabolite exposure.

Figure 1:

(A) Comparison of measured oseltamivir (left) and metabolite (right) concentrations to the oseltamivir PK prediction model by Kamal et al. [7]. Measured concentrations of oseltamivir and its active metabolite, oseltamivir carboxylate, for our study population were superimposed onto the median (solid blue lines) and 90% prediction interval (area between dashed lines) of an oseltamivir pharmacokinetic model based on data from pediatric, adult and geriatric patients. (Amended with permission from American Society for Microbiology) (B) Comparison of estimated mean C_max and AUC_0–12hr of OC metabolite between PO and tube groups. (Left) C_max of OC and (right) AUC_0–12hr of OC. The p values compare the means between the two groups. PO = oral administration. Tube = enteric tube administration. C_max = estimated maximum concentration. AUC = estimated Area Under the Curve. Statistical significance defined as p≤0.05 using student’s t-test.