Rising Oseltamivir Use Among Hospitalized Children in a Postpandemic Era
- 1 March 2016
- journal article
- Published by American Academy of Pediatrics (AAP) in Hospital Pediatrics
- Vol. 6 (3), 172-178
- https://doi.org/10.1542/hpeds.2015-0126
Abstract
BACKGROUND: Oseltamivir prescribing among pediatric inpatients with influenza varied from 2% to 48% prior to the 2009 H1N1 pandemic. After the pandemic, prescribing guidelines were expanded, and studies reported benefits for hospitalized children. Post-pandemic prescribing practices among children are unclear. OBJECTIVES: To report the rate of oseltamivir use and to identify factors associated with its use among inpatients with confirmed influenza infection from 2010 to 2014 at a tertiary children’s hospital. METHODS: We conducted a retrospective cohort study of inpatients with polymerase chain reaction–confirmed influenza from December 2010 to April 2014 at Children’s Hospital Colorado. The primary outcome was oseltamivir use. Variables regarding demographics, underlying medical conditions, diagnoses, and hospital course were also explored. Univariate and multivariate logistic regression analyses were performed. RESULTS: Among 395 inpatients with influenza, 323 (82%) received oseltamivir. In univariate analyses, oseltamivir use was associated with admission within 48 hours of symptom onset (89% vs 77%), ICU admission (88% vs 79%), longer length of stay (90% for >6 days vs 77% for ≤2 days), and influenza A H1N1 infection (P < .05 for all). In multivariate logistic regression analysis, longer length of stay, illness during the 2013–2014 season, and admission within 48 hours of symptom onset were associated with higher odds of oseltamivir use. CONCLUSIONS: Oseltamivir use for children with influenza in the postpandemic era is increasing at our institution, aligning with official recommendations and reported benefits. We report highest use for patients in the 2013–2014 season, those who present early in their illness, and those requiring a prolonged hospital stay.Keywords
This publication has 21 references indexed in Scilit:
- Neuraminidase Inhibitors for Critically Ill Children With InfluenzaPEDIATRICS, 2013
- The Burden of Influenza in Young Children, 2004–2009Published by American Academy of Pediatrics (AAP) ,2013
- Reduced Influenza Antiviral Treatment Among Children and Adults Hospitalized With Laboratory-Confirmed Influenza Infection in the Year After the 2009 PandemicClinical Infectious Diseases, 2012
- Rapid Increase in Use of Antiviral Therapy for Hospitalized Children With Influenza During the 2009 H1N1 EpidemicThe Pediatric Infectious Disease Journal, 2011
- Hospitalized Children with 2009 Pandemic Influenza A (H1N1): Comparison to Seasonal Influenza and Risk Factors for Admission to the ICUPLOS ONE, 2010
- Burden of Seasonal Influenza Hospitalization in Children, United States, 2003 to 2008The Journal of Pediatrics, 2010
- Critically Ill Patients With 2009 Influenza A(H1N1) Infection in CanadaPublished by American Medical Association (AMA) ,2009
- Treatment with oseltamivir in children hospitalized with community‐acquired, laboratory‐confirmed influenza: Review of five seasons and evaluation of an electronic reminderJournal of Hospital Medicine, 2009
- Antiviral Therapy and Prophylaxis for Influenza in ChildrenPEDIATRICS, 2007
- Multistate Surveillance for Laboratory-Confirmed, Influenza-Associated Hospitalizations in ChildrenThe Pediatric Infectious Disease Journal, 2006