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Oseltamivir Prevents Complications of Influenza in High-Risk Children

Oseltamivir prescribed within 1 day of clinical diagnosis of influenza reduced risks for complications and hospitalization in children with chronic conditions.

In a manufacturer-sponsored study, investigators examined the effects of oseltamivir on influenza-related complications in children with chronic diseases. Using an administrative claims database, the investigators compared outcomes in 1634 children who received an oseltamivir prescription within 1 day of influenza diagnosis and 3721 children who did not receive antiviral therapy after influenza diagnosis. All children (age range, 1–17 years) were considered to be at high risk for complications because of a chronic disease (including HIV/AIDS, asthma, cancer) and received diagnoses of influenza between the 2000 and 2006 flu seasons.

During the 14 days after influenza diagnosis, children who received oseltamivir were less likely than those who did not receive oseltamivir to be hospitalized (0.6% vs. 1.3%) and to have pneumonia (1.0% vs. 1.9%), a respiratory illness other than pneumonia (19.8% vs. 23.8%), and otitis media (2.8% vs. 4.9%). In analyses adjusting for potential confounders, all these differences were statistically significant except for the difference in pneumonia outcomes. Results were similar 30 days after diagnosis.

Comment: This study is an excellent example of comparative effectiveness research. Using observational data, these investigators found that oseltamivir prevents complications of influenza in high-risk children. These children were not infected with the novel H1N1 ("swine flu") virus. However, readers should note that the FDA has granted emergency approval for the use of oseltamivir for treatment or prevention of 2009 influenza A (H1N1) in adults and children — including those younger than 1 year. For specific information, visit the CDC website.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine August 5, 2009

Citation(s):

Piedra PA et al. Effects of oseltamivir on influenza-related complications in children with chronic medical conditions. Pediatrics 2009 Jul; 124:170.

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Reader Remarks:

Review and add to remarks on this article

• oseltamivir
  rt lis, 6 Aug 2009 12:34 PM EST
  In my opinion, this article is an 'excellent example' of an industry sponsored study that found to its advantage. Did... [more]
• Resistence to Oseltamivir
  Rodolfo Milani - Jr, Sao Paulo University - Brazil, 6 Aug 2009 12:34 PM EST
  During last flu season, almost all (99,6%) seasonal Influenza A H1N1 were resistant to oseltamivir. A question: are this paper... [more]
• No mention of death rates between the groups was offered.
  Leonard M. Saputo, 7 Aug 2009 12:28 PM EST
  What was the difference in death rates between the two groups?
• Death rates
  Lyn Whinston-Perry, Executive Editor, JW Pediatrics and Adolescent Medicine, 10 Aug 2009 5:16 PM EST
  Specialty: Unknown
  The study outcomes were frequencies of pneumonia, respiratory illnesses other than pneumonia, otitis media, and hospitalization. The authors did not... [more]
• oseltamivir resistance
  Peggy Sue Weintrub, MD, Associate Editor, JW Pediatrics and Adolescent Medicine, 11 Aug 2009 3:37 PM EST
  Dr. Milani poses an insightful question and points out a difficulty we will all face in the upcoming respiratory season.... [more]
• Not comparative effectiveness research
  David S. Herr, 28 Aug 2009 2:18 PM EST
  Dear Dr. Bauchner, I respectfully disagree with your statement that this article is an example of comparative effectiveness research, because... [more]
• Author response to David Herr on comparative effectiveness research
  Howard Bauchner, MD, JW Pediatr Adolesc Med, Associate Editor, 31 Aug 2009 4:29 PM EST
  David -
  
  Seems like a fair point - but in this case are there any other drugs that could have... [more]

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