Despite the lack of strong evidence to support the recommendation, the severity of the 2009 influenza pandemic prompted the World Health Organization (WHO) to advise that higher doses of oseltamivir (150 mg twice daily) and longer treatment regimens (> 5 days) should be considered when treating severe or progressive illness.
So, does the data support higher dosing in critically ill influenza patients?
A new systematic review concluded that "the small body of literature available in humans does not support routine use of high-dose oseltamivir in critically ill patients."
References
Flannery AH, et al. Oseltamivir dosing in critically ill patients with severe influenza. Ann Pharmacother 2014;48(8):1011-8. [PMID 24816209]
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