Do pediatricians manage influenza differently than internists?

Area of Science:

• Infectious Diseases
• Pediatrics
• Internal Medicine

Background:

• Limited understanding of how pediatricians and internists manage influenza symptoms.
• Current Centers for Disease Control and Prevention (CDC) guidelines for antiviral prescribing do not differentiate between adults and children.
• Need to describe and compare influenza management strategies between pediatricians and internists.

Purpose of the Study:

• To describe how pediatricians manage influenza in two academic medical institutions.
• To compare the influenza management practices of pediatricians with those of internists.

Main Methods:

• Cross-sectional online survey of physician knowledge, attitudes, and practices regarding influenza diagnosis and antiviral therapy.
• Survey conducted at the end of the 2003-4 influenza season at two large academic medical centers.
• Data collected on demographics, rapid diagnostic testing use, antiviral prescribing patterns, and beliefs about influenza and antiviral drugs.

Main Results:

• Pediatricians were more likely than internists to perform rapid influenza testing (74% vs. 47%).
• Pediatricians were more likely to use amantadine (88% vs. 48%) and restrict prescribing to high-risk patients (86% vs. 53%).
• Pediatricians were more likely to believe antiviral therapy could decrease mortality (38% vs. 22%), while internists were less familiar with or lacked access to rapid testing.

Conclusions:

• Significant differences exist in how pediatricians and internists manage influenza.
• Development of evidence-based guidelines tailored to the specific needs of pediatric and adult patient populations is recommended.
• Further research may elucidate optimal influenza management strategies for different age groups.