Antiviral treatment of influenza in children: a retrospective cohort study
Insights
Antiviral treatment for influenza in children significantly reduces complications and healthcare use, particularly when started early. This finding is crucial for managing pediatric flu cases and improving outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Epidemiology
- Pharmacotherapy
Background:
- Influenza poses a significant health risk to children, with potential for serious complications.
- Understanding risk factors and treatment effects is vital for pediatric influenza management.
Purpose of the Study:
- To investigate the incidence of influenza complications in children.
- To identify risk factors associated with influenza complications in pediatric populations.
- To evaluate the impact of antiviral treatment on influenza complications and healthcare resource utilization.
Main Methods:
- Retrospective cohort study utilizing US insurance claims data (2006-2010).
- Inclusion criteria: children aged ≤17 years with influenza diagnosis (ICD-9-CM codes 487.xx or 488.xx).
- Unconditional logistic regression analyzed antiviral treatment effects on 30-day outcomes; sub-analysis for infants (<1 year).
Main Results:
- Antiviral treatment was administered to 39.53% of 797,284 pediatric influenza cases.
- Pre-existing conditions like asthma and cystic fibrosis increased complication risk.
- Antiviral treatment lowered the 30-day risk of complications, hospitalization, and emergency visits (ORs < 1).
- Early antiviral treatment (within 2 days) further reduced healthcare resource utilization, especially in infants.
Conclusions:
- Antiviral therapy is associated with decreased complications and healthcare resource utilization in children with influenza.
- Early initiation of antiviral treatment is key to maximizing benefits in pediatric influenza patients.
- Findings support the use of antiviral medications for managing influenza in children across all age groups.
Introduction:
Influenza is a common and potentially serious disease in children. This retrospective cohort study examined the incidence of complications and associated risk factors in this population, and the effects of antiviral treatment.
Methods:
Data for children aged ≤17 years with a clinical diagnosis of influenza (ICD-9-CM codes 487.xx or 488.xx) during the 2006-2010 influenza seasons (including the 2009-2010 pandemic season) were obtained from US insurance claims databases. Unconditional logistic regression was used to evaluate the effect of antiviral treatment on the incidence of complications and healthcare resource utilization during the 30 days post the index influenza diagnosis. A sub-analysis in children aged <1 year was performed.
Results:
Antiviral treatment was used in 315,128 (39.53%) of 797,284 cases. The risk of complications was higher in children with pre-existing conditions, e.g., asthma (odds ratio [OR] = 1.86) or cystic fibrosis (OR = 1.67) than otherwise healthy children. Antiviral treatment reduced the 30-day risk of complications, hospitalization, emergency department visits, and ≥2 outpatient visits versus no treatment (ORs = 0.76, 0.69, 0.76, and 0.81, respectively); 30-day risks were further reduced by early treatment (within 2 days of diagnosis). The sub-analysis included 19,666 children aged <1 year; 7.38% received antiviral treatment during the pre-pandemic seasons and 33.00% during the pandemic season. Findings were similar to the main analyses; however, healthcare resource utilization was only significantly reduced by early treatment.
Conclusions:
Antiviral treatment is associated with reduced risk of complications and healthcare resource utilization in children of all ages with influenza, especially when initiated early.
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