ABSTRACT
Under the Emergency Use Authorization issued in April 2009, oseltamivir can be used to treat 2009 influenza A (H1N1) virus infection in children aged <1 year. No data exist on the dosing of oseltamivir in premature babies. A hospital health care worker inadvertently exposed 32 neonatal intensive care unit babies to 2009 influenza A (H1N1); a protocol was expeditiously implemented to collect samples for pharmacokinetics and dosage evaluation. Results suggest 1.0 mg/kg/dose twice daily in premature babies produces oseltamivir carboxylate exposures similar to that in older children receiving 3.0 mg/kg/dose twice daily. These results provide initial guidance on dosing oseltamivir in this vulnerable population.
Subject(s)
Antiviral Agents/administration & dosage , Antiviral Agents/pharmacokinetics , Influenza, Human/drug therapy , Oseltamivir/administration & dosage , Oseltamivir/pharmacokinetics , Adult , Cross Infection/drug therapy , Cross Infection/virology , Female , Humans , Infant, Newborn , Infant, Premature , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/virology , MaleABSTRACT
OBJECTIVES: Aminophylline has proven useful for treating renal failure in preterm infants. Previous reports state that aminophylline is incompatible with some neonatal total parenteral nutrition (TPN) solutions. If this is correct, administration of aminophylline doses would be complicated by the need to hold TPN and provide flush solution after each aminophylline dose. Our experience with administering aminophylline over 30 minutes concurrently with TPN was that this was not problematic. We therefore examined the in vitro compatibility of aminophylline and TPN solutions used in our neonates over a 30-minute interval to see if our policy of allowing concurrent mixing of these products was appropriate. METHODS: TPN solutions (2.5 mL) were mixed with 1 mL of intravenous aminophylline 2.5 mg/mL in a glass vial. Three different TPN solutions used in our NICU were collected for the study, and five samples of each combination were prepared. Samples were watched for 60 minutes to see if precipitation occurred. RESULTS: Although the aminophylline and TPN solutions were not miscible, no turbidity or precipitation was observed. CONCLUSIONS: This study supports that aminophylline is physically compatible with neonatal TPN for 60 minutes.