Antiviral treatment lowers ICU risk for children with influenza

A new nationwide study finds antiviral treatment is linked to fewer intensive care unit (ICU) admissions and shorter hospital stays for children hospitalized with influenza.

The study, published today in JAMA Pediatrics and led by experts at the University of Colorado Anschutz, is one of the most comprehensive real-world evaluations of antiviral treatment in pediatric influenza to date.

The research found that children who received early treatment with antiviral treatment, in this case oseltamivir, were 31% less likely to be admitted to an ICU and had shorter hospital stays than those who did not receive the antiviral.

The findings come as use of antiviral medications among hospitalized children with influenza has declined despite national guidelines recommending treatment for suspected or confirmed cases.

After one of the most severe influenza seasons in the past two decades, these findings reinforce the importance of treating children with influenza who are hospitalized. Our findings show that oseltamivir treatment can decrease the risk of needing critical care, even if started beyond the first two days of the start of the illness." 

Suchitra Rao, MD, paper's senior author, professor in the department of pediatrics, University of Colorado Anschutz School of Medicine and infectious disease specialist, Children's Hospital Colorado

One of the largest and most rigorous real-world evaluations

The researchers looked at data from more than 7,000 pediatric hospitalizations captured through a FluSurv-NET, a CDC-supported surveillance network that captures laboratory-confirmed influenza hospitalizations. The data spanned 13 states and eight influenza seasons.

Unlike many earlier observational studies, this research accounted for when symptoms began and when antiviral treatment started, providing stronger real-world evidence on the effectiveness of oseltamivir in hospitalized children.

"Earlier studies were often missing key information about when children became sick or whether they started antiviral treatment before being hospitalized, making it harder to evaluate the medication's effectiveness. By capturing those details and using advanced statistical methods, we were able to produce stronger real-world evidence to inform the care of children hospitalized with influenza," adds Rao.

The findings reinforce current national recommendations that children hospitalized with suspected or confirmed influenza receive an antiviral medication as soon as possible.