Among children hospitalized for influenza, treatment with the antiviral drug oseltamivir reduced the risk of admission to an intensive care unit (ICU) by 31% and shortened hospital stays, concludes a real-world study published yesterday in JAMA Pediatrics.
The study, led by University of Colorado (UC) Anschutz researchers, analyzed data on hospitalized children who received or didn’t receive oseltamivir (eg, Tamiflu) in the Influenza Hospitalization Surveillance Network, which operates in 13 states, during eight respiratory virus seasons (2014-15 through 2022-23, except for 2020-21).
“National organizations recommend antiviral treatment for hospitalized children with influenza; however, use in this setting has recently declined,” the researchers wrote. “Studies of oseltamivir effectiveness in children are limited by misclassification bias, unknown symptom onset date, and incomplete capture of antiviral use prior to admission.”
Findings support current national guidelines
Of 6,044 pediatric flu patients in the primary ICU analysis, 70.2% received oseltamivir. In the secondary hospital length-of-stay (LOS) analysis, 80.9% of 7,103 patients received oseltamivir.
After adjustment, compared with untreated children, oseltamivir treatment reduced the risk of ICU admission 31%. Both early (within two days of admission) and late treatment were tied to a 26% and 45% lower risk of ICU admission, respectively, compared with no treatment.