Oseltamivir may lower influenza-related complications in children

  • Lee JJ & al.
  • Eur Respir J
  • 11 Jun 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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.