title: Postpartum pharmacokinetics of peramivir in the treatment of 2009 H1N1 influenza.
abstract: BACKGROUND
  2009 H1N1 influenza A disproportionately affected pregnant and postpartum women compared with the general population, with higher rates of hospitalization and severe illness. We present a case of the use and pharmacokinetics of intravenous peramivir in the treatment of a patient with severe influenza.
  
  
  METHODS
  A 28-year-old woman at 37 weeks of gestation presented to the hospital with severe respiratory symptoms. 2009 H1N1 influenza reverse transcriptase polymerase chain reaction returned positive results and intravenous peramivir was started. She showed rapid improvement and was discharged 29 days after admission.
  
  
  CONCLUSIONS
  The pharmacokinetic parameters in this patient were unexpected because the clearances occurred more quickly than in phase I trials. These differences highlight the need for additional pharmacokinetic reporting of peramivir in pregnant and postpartum women.
authors.affiliation: From the Kansas City University of Medicine and Biosciences, Kansas City, Missouri; Liberty Hospital, Liberty, Missouri; St. Louis College of Pharmacy, Affton, Missouri; and Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Clay
authors.forename: Raghavendra B
authors.initials: RB
authors.lastname: Adiga
authors.forename: Tracey A H
authors.initials: TAH
authors.lastname: Taylor
authors.forename: Rachael
authors.initials: R
authors.lastname: Alsup
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Gerk
authors.forename: MaryPeace
authors.initials: M
authors.lastname: McRae
mesh_terms: D000146:Acids, Carbocyclic; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002585:Cesarean Section; D003517:Cyclopentanes / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D004196:Disease Outbreaks; D005260:Female; D006146:Guanidines / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects*; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D053139:Oseltamivir / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000146:Acids, Carbocyclic; D000998:Antiviral Agents; D003517:Cyclopentanes; D006146:Guanidines; D053139:Oseltamivir; C414210:peramivir