Reporting on Adverse Clinical Events

A retrospective review of critically ill adult patients was performed to assess the association between oseltamivir and bradycardia. A total of 203 critically ill adults with presumed influenza who had received at least 2 doses of oseltamivir were included in the assessment. The primary outcome was the occurrence of bradycardia (heart rate: ≤59 beats/min) while receiving oseltamivir or a decrease of at least 20 beats/min compared with the lowest heart rate before initiating oseltamivir. Results: Less than half of the patients (43.4%) had documented bradycardia, 59 had a heart rate ≤ 59 beats/min, 19 with a heart rate decrease of at least 20 beats/min, and 10 with both. The time of onset from first dose to bradycardia was 51.4 hours. Approximately half (54.6%) of the patients received treatment for bradycardia. A multivariate logistic regression showed that bradycardia was associated with baseline heart rate, age, past medical history of neurologic issues, and positive influenza status. Based on the results of this study, the authors concluded that oseltamivir was associated with clinically relevant bradycardia in critically ill patients. They suggested that critically ill patients who receive oseltamivir should be monitored for bradycardia. Oseltamivir [Oseltamivir] MacLaren R et al (Robert MacLaren: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Blvd, C238, Aurora, CO 80045; e-mail: rob.maclaren@cuanschutz.edu) Oseltamivirassociated bradycardia in critically ill patients. Ann Pharmacotherapy 55:1318–1325 (Nov) 2021