Oseltamivir May Lower Influenza-related Complications in Children

Sarfaroj Khan 

June 24, 2020

Takeaway

  • Oseltamivir was associated with a small but statistically significant reduction in influenza-related complications in children presenting in primary care with influenza/influenza-like illness (ILI) during the 2009-10 pandemic.

Why this matters

  • Findings support the current practice of limiting prescribing to periods of high influenza activity.

  • Future high quality randomised controlled trials are needed to substantiate these findings and inform efficient, cost-effective strategies for prescribing antivirals.

Study design

  • This retrospective cohort study included 16,162 children with influenza/ILI (aged, ≤17 years) using data from the UK Clinical Practice Research Datalink (CPRD) during the 2009-2010 pandemic.

  • Primary outcome: any influenza-related complications.

  • Funding: National Institute for Health Research School for Primary Care Research.

Key results

  • Of 16,162 children, 4028 (24.9%) were prescribed oseltamivir and influenza-related complications were recorded in 753 (4.7%).

  • In propensity score analyses, oseltamivir prescriptions were associated with reduced:

    • influenza-related complications (risk difference [RD], −0.015; 95% CI, −0.022 to −0.008; P<.0001).

    • complications requiring further intervention (RD, −0.006; 95% CI, −0.012 to −0.001; P=.0201);

    • pneumonia (RD, −0.002; 95% CI, −0.003 to −0.001; P<.0001);

    • pneumonia or hospitalisation (RD, −0.004; 95% CI, −0.006 to −0.001; P=.0041); and

    • influenza-related hospitalisation (RD, −0.003; 95% CI, −0.005 to −0.001; P=.023), but not all-cause hospitalisation (RD, −0.003; 95% CI, −0.007 to 0.0003; P=.0737).

  • In adjusted instrumental variable analyses, oseltamivir was linked to reduction in:

    • influenza-related complications (RD, −0.032; 95% CI, −0.051 to −0.013; P=.0007);

    • pneumonia or hospitalisation (RD, −0.009; 95% CI, −0.017 to −0.002; P=.0102); 

    • all-cause hospitalisation (RD, −0.028; 95% CI, −0.051 to −0.006; P=.0141); and

    • influenza-related hospitalisation (RD -0.021; 95% CI, -0.039 to -0.003; P=.0226).

Limitations

  • Retrospective design.

Lee JJ, Smith M, Bankhead C, Perera Salazar R, Kousoulis AA, Butler CC, Wang K. Oseltamivir and influenza-related complications in children: a retrospective cohort in primary care. Eur. Respir. J.2020 Jun 11 [Epub ahead of print]. doi: 10.1183/13993003.02246-2019. PMID: 32527739.  Abstract. 

This clinical summary first appeared on Univadis, part of the Medscape Professional Network.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....