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Safety and Efficacy of Oseltamivir in Children Younger Than One Year of Age

Information source: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Influenza

Intervention: Oseltamivir (Drug)

Phase: Phase 2

Status: Withdrawn

Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)

Official(s) and/or principal investigator(s):
Bob Taylor, MD, Principal Investigator, Affiliation: Mahidol Oxford University Research


Currently, there is no standard treatment for influenza with related lower respiratory tract infection (LRTI) in children younger than one year of age, even though influenza related LRTI is a potentially fatal illness in these children. This study will test a medicine for influenza in children younger than one year of age to see if it is safe and effective.

Clinical Details

Official title: Oseltamivir Treatment in Children Under One Year of Age With Moderate or Severe Influenza Lower Respiratory Tract Infection - a Clinical and Pharmacokinetic Study

Study design: Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome:

Viral clearance of human influenza on a nose and throat swab, assessed by reverse transcriptase polymerase chain reaction (RT PCR)

Viral clearance of H1N1 swine influenza, version found in Vietnam only, on a nose and throat swab, assessed by RT PCR

Viral clearance of avian influenza on a nose and throat swab, assessed by RT PCR

Secondary outcome:

Time to viral clearance on a throat and nose swab, assessed by RT PCR

The time to no detectable influenza virus by culture for the throat and nose swabs

Change in viral load (by log10 copies/mL) over time for all virological samples, with a lower limit of detection of 1,000 copies/mL

Viral susceptibility of cultured influenza virus to antiviral drugs, assessed by genotypical and phenotypical analyses

Time to fever clearance

In-hospital mortality and mortality by follow-up

Time to death

Time to trans-cutaneous O2 saturation of greater than or equal to 95% on room air

Clinical course: pneumothorax, encephalitis/encephalopathy

Number of days in hospital

Number of days ventilated

Documented serious adverse events (SAEs) and relationships to oseltamivir

Adverse events (AEs) leading to drug withdrawal

Grade 3 and 4 clinical and laboratory AEs that are probably or definitely related to oseltamivir

Skin rashes of any grade

Changes in hematological and biochemical parameters over time

Pharmacokinetic endpoints, including maximum concentration (Cmax), time of Cmax (Tmax), steady state minimum concentration (Cmin), area under the curve (AUC), and volume of distribution

Detailed description: Influenza-related lower respiratory tract infection (LRTI) can cause serious illness or death in children younger than a year old. Only four medications are registered to treat influenza, and these do not have detailed recommendations for treating children younger than one year of age. One of these medications, oseltamivir, has no official recommendation for usage in children younger than one year of age, but it may be the best treatment for certain strains of influenza. A small number of children younger than one year of age have received oseltamivir in several countries with good clinical outcomes and apparently good tolerability. This study will test oseltamivir in children younger than one year of age to see if it is safe and effective. Children younger than one year of age with influenza will be recruited for this study. Participants will receive the usual care for influenza with the addition of oseltamivir. Oseltamivir will be given orally for 5 days to children with human influenza, 7 days to children with H1N1 influenza in Vietnam, and 10 days to children with avian influenza. Participants will need to remain in the hospital between 5 and 12 days, depending on their illnesses. Study assessments will be performed daily for 14 days with follow-up examinations occurring 1 to 2 weeks, 6 months, and 12 months after study entry. These assessments will include normal tests for children with influenza, such as blood tests and chest x-rays, but additional blood and nose, throat, and mouth samples will be collected for the study. Participants on a breathing machine will give lung samples.


Minimum age: 1 Month. Maximum age: 12 Months. Gender(s): Both.


Inclusion Criteria:

- Informed consent signed by a parent or legal guardian

- Younger than 12 months of age when first seen with a lower respiratory tract

infection (LRTI)

- LRTI must be moderate or severe and influenza must be virologically proven by a

respiratory specimen

- History of fever within 14 days prior to presentation (although fever at presentation

is not required) plus any two of the following: cough, difficulty breathing or shortness of breath, increased respiratory rate for current age, intercostal recession, use of accessory muscles, nasal flare or grunting, crepitations with or without wheezing, a consistent abnormal chest x-ray (e. g., new infiltrate, hyperinflation)

- Virological evidence of influenza on any one of the tests specified in the protocol

Exclusion Criteria for Children with Non-Avian Influenza:

- Known allergy to oseltamivir

Additional Exclusion Criteria for Children with Non-Avian Influenza:

- Illness duration greater than 14 days on the day of hospital admission

- Creatinine clearance less than 10 mL/min/1. 73m2, including a requirement for dialysis

or hemofiltration

Locations and Contacts

Additional Information

Related publications:

Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM, Kapoor SK, Fowler K, Sullender WM. A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India. PLoS One. 2007 Jun 6;2(6):e491.

American Academy of Pediatrics Committee on Infectious Diseases. Antiviral therapy and prophylaxis for influenza in children. Pediatrics. 2007 Apr;119(4):852-60. Review.

Ferraris O, Lina B. Mutations of neuraminidase implicated in neuraminidase inhibitors resistance. J Clin Virol. 2008 Jan;41(1):13-9. Epub 2007 Dec 11. Review.

Starting date: March 2010
Last updated: August 5, 2014

Page last updated: August 23, 2015

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