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Oseltamivir Associated With Improved Outcomes for Younger Patients with Influenza
Oseltamivir is tied with improved outcomes for younger patients with influenza according to a recent study published in the JAMA Pediatrics.
Oseltamivir is recommended for all children hospitalized with influenza, despite limited evidence supporting its use in the inpatient setting.
A study was conducted to determine whether early oseltamivir use is associated with improved outcomes in children hospitalized with influenza.
This multicenter retrospective study included 55 799 children younger than 18 years who were hospitalized with influenza from October 1, 2007, to March 31, 2020, in 36 tertiary care pediatric hospitals who participate in the Pediatric Health Information System database. Data were analyzed from January 2021 to March 2022.
The primary outcome was hospital length of stay (LOS) in calendar days. Secondary outcomes included 7-day hospital readmission, late (hospital day 2 or later) intensive care unit (ICU) transfer, and a composite outcome of in-hospital death or use of extracorporeal membrane oxygenation (ECMO). Inverse probability treatment weighting (IPTW) based on propensity scoring was used to address confounding by indication. Mixed-effects models were used to compare outcomes between children who did and did not receive early oseltamivir treatment. Outcomes were also compared within high-risk subgroups based on age, presence of a complex chronic condition, early critical illness, and history of asthma.
Results:
- The analysis included 55 799 encounters from 36 hospitals.
- The median (IQR) age of the cohort was 3.61 years (1.03-8.27); 56% were male, and 44% were female. A total of 33 207 patients (59.5%) received early oseltamivir.
- In propensity score–weighted models, we found that children treated with early oseltamivir had shorter LOS and lower odds of all-cause 7-day hospital readmission, late ICU transfer, and the composite outcome of death or ECMO use
Thus, early use of oseltamivir in hospitalized children was associated with shorter hospital stay and lower odds of 7-day readmission, ICU transfer, ECMO use, and death. These findings support the current recommendations for oseltamivir use in children hospitalized with influenza.
Reference:
Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM. Association of Early Oseltamivir With Improved Outcomes in Hospitalized Children With Influenza, 2007-2020. JAMA Pediatr. Published online September 19, 2022. doi:10.1001/jamapediatrics.2022.3261
Keywords:
Oseltamivir, Improved, Outcomes, Younger, Patients, Influenza, Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM, JAMA Pediatrics
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751