Assessing the safety of oseltamivir in transplant recipients

Is it safe to use oseltamivir as prophylaxis against influenza in patients undergoing hematopoietic stem cell transplantation (HSCT)? Yes, according to this case-control study.

In 2002, an outbreak of infection with influenza A virus occurred in an outpatient residential facility for patients undergoing HSCT. Prophylaxis with oseltamivir, 75 mg/d for a median of 17 days, was given to all asymptomatic residents. Vu and associates retrospectively studied 25 patients who had undergone HSCT and 20 who were pre-HSCT candidates. A control group consisted of patients who underwent HSCT from 1994 to 2003 and did not receive influenza prophylaxis.

Adverse events were scored according to the National Cancer Institute Common Terminology Criteria, version 3.0, and were graded on a scale of 0 to 5 (1 is a mild event, 2 is moderate, 3 is severe, 4 is disabling, and 5 is fatal).

No new cases of influenza A virus infection were identified in the facility. Influenza B virus infection occurred in 2 patients--1 who was noncompliant with prophylaxis and 1 who did not receive prophylaxis at all. There were no deaths associated with oseltamivir prophylaxis. The cases and controls did not differ significantly in the incidence of clinical or laboratory adverse events that were graded as 2 to 4 or 3 to 4.