December 20, 2023
Healio reports the findings of a study into the use of antivirals to treat influenza in children. The study authors chose to look at the pediatric population as prior work had looked at variability in adults. With four FDA-approved options, the treatments are widely available yet only 37% of children in the study were dispensed an antiviral. Several organizations, including CDC, recommend using antiviral treatments for children with the flu.
Those recommendations strongly support the use of antivirals in children with the flu that are at high risk for complications. They also include guidelines on when to use and who to consider high risk that were used by researchers when investigating the data. Study authors reviewed claims from a national pharmacy database, Narrative MarketScan Commercial Claims, representing all 50 states from 2010 to 2019. Their analysis included nearly 1.5 million unique antiviral dispensations.
Researchers found 63.3% of antiviral dispensations were for children with risk factors for flu complications. Children under two years of age, which the guidelines suggest should receive an antiviral regardless of symptom duration, only received an antiviral in 37% of cases. The most frequently prescribed antiviral to this group (99.8%) was Oseltamivir.
While acknowledging that flu vaccines may be the most powerful tool to protect children from influenza, study authors note the use of antivirals have been thoroughly studied and found to be safe and effective in children. They state increased, judicious use may help improve outcomes for children with influenza and suggest more awareness of antiviral use and safety among parents would be beneficial.
PIDS member Pia Pannaraj wrote in an accompanying commentary that there is an urgent need for better understanding of factors contributing to a lack of guideline adherence, “As life and human behavior have returned to prepandemic norms, influenza will circulate at higher rates in the community once again. Influenza vaccine effectiveness is known to vary greatly each season, and vaccination rates in children decreased during the coronavirus disease 2019 pandemic.”