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.
