Oseltamivir Lowers ICU Risk in Children With Influenza: Study
A real-world study has revealed that oseltamivir reduced the risk of flu-related ICU admission by 31% in children, regardless of how soon treatment was started. It was also associated with shorter hospital stays, supporting its use in children hospitalized with influenza. The study was published in JAMA Pediatrics by Kacie R. and colleagues.
To determine the therapeutic effect of oseltamivir, the researchers considered information collected through FluSurv-NET, a population-based surveillance program monitoring laboratory-confirmed influenza-related hospitalizations in 13 U.S. states. Information was obtained during flu seasons ranging from 2014–2015 to 2022–2023 (2020–2021 was excluded), and involved children less than 18 years old with confirmed dates of symptom onset. Information analysis was performed from October 2024 to May 2026. The main variable was the time from symptom onset to ICU admission and covered 6,044 patients, including 4,240 (70.2%) who had received oseltamivir.
Secondary outcome time from admission to discharge (LOS) included 7,103 cases, of which 5,746 (80.9%) were on oseltamivir treatment. The median age for the primary intensive care unit analysis cohort was 3 (IQR, 1–7) years. There were 3,382 (56%) males, 3,721 (44%) females, and 2,937 (49%) patients who had chronic disease conditions, mainly asthma in 1,547 children (26%). Adjusted Cox proportional hazard models were used to obtain adjusted hazard ratios (aHR).
Key findings:
- Oseltamivir receipt significantly lowered the hazard of ICU admission compared with no antiviral treatment (aHR, 0.69; 95% CI, 0.60–0.80), representing a 31% relative risk reduction.
- Treatment significantly accelerated the rate of hospital discharge (aHR, 1.13; 95% CI, 1.06–1.21), demonstrating a statistically significant reduction in overall hospital LOS.
- The primary ICU analysis included 6,044 pediatric cases (70.2% treated with oseltamivir), while the secondary LOS analysis comprised 7,103 cases (80.9% treated with oseltamivir).
- Forty-nine percent (2,937) of children in the primary ICU cohort possessed underlying chronic conditions, with asthma identified as the single most prevalent comorbidity (26% [1,547 children]).
In summary, oseltamivir treatment in hospitalized pediatric influenza patients offers substantial clinical benefit by lowering the risk of ICU admission by 31% and decreasing hospital stay.
Reference:
Rytlewski K, Dunn A, O’Halloran A, et al. Effectiveness of Oseltamivir in Hospitalized Children With Laboratory-Confirmed Influenza, 2014-2023. JAMA Pediatr. Published online August 10, 2026. doi:10.1001/jamapediatrics.2026.3376
