Dulek DE, Williams JV, Creech CB, Schulert AK, Frangoul HA, Domm J, Denison MR, Chappell JD. Use of intravenous zanamivir after development of oseltamivir resistance in a critically Ill immunosuppressed child infected with 2009 pandemic influenza A (H1N1) virus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2010 Jun 1;50(50). 1493-6. PMID: 20415572 [PubMed]
Immunosuppressed patients receiving oseltamivir for 2009 novel H1N1 influenza A infection may develop drug resistance, leading to treatment failure. Intravenous zanamivir was administered on a compassionate-use basis to a profoundly immunosuppressed pediatric patient with severe oseltamivir-resistant novel H1N1 pneumonia. The regimen was well tolerated and was associated with a decrease in viral burden.