Both neuraminidase inhibitors (oseltamivir and zanamivir) are active against the novel H1N1v 2009 pandemic influenza A strain. The recommended adult dose for oseltamivir, considered the first-line therapy for H1N1 influenza infection, is 75 mg orally twice a day for a total of 5 days [44] . Dose adjustment may be required in the presence of reduced creatinine clearance, but the dosage should be maintained for patients undergoing continuous venovenous hemodialysis. A recent World Health Organization treatment guideline for pharmacological management of 2009 pandemic H1N1v influenza A recommends the consideration of higher doses of oseltamivir (150 mg twice a day) and longer duration of treatment for patients with severe influenza pneumonia or clinical deterioration [44] . Since hospitalized patients can shed influenza virus for prolonged periods of time, extending antiviral treatment beyond the first 5 days of treatment in cases of persistent influenza symptoms may be necessary. However, clear guidelines for these circumstances have not been established, and clinical trials examining the appropriate treatment dose and duration for severe H1N1 influenza in various patient populations are acutely needed.