Oseltamivir treatment of influenza A and B infections in infants
Janna-Maija Mattila1, Tytti Vuorinen2, Matti Waris2
1Department of Pediatrics, University of Turku, Turku University Hospital, Turku, Finland.
Insights
Oseltamivir treatment significantly reduced influenza illness duration and severity in young infants. This antiviral is effective against influenza A and B, especially in newborns lacking licensed vaccines.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Pharmacology
Background:
- Influenza management in infants is limited as vaccines are not licensed for this age group.
- Oseltamivir is the primary treatment option for influenza in young infants.
- Limited data exist on oseltamivir's effectiveness in treating influenza in neonates.
Purpose of the Study:
- To evaluate the effectiveness of oseltamivir in treating influenza in newborn infants.
- To assess the impact of oseltamivir on viral load and symptom duration in infants.
- To compare the efficacy of oseltamivir against influenza A and B in this population.
Main Methods:
- Prospective study of 431 infants followed for 10 months during the respiratory season.
- Nasopharyngeal specimens collected to determine viral etiology and viral load.
- Infants with influenza symptoms <48 hours received oseltamivir; daily symptom diaries were maintained.
Main Results:
- Oseltamivir recipients with influenza A had a mean illness duration of 82.1 hours vs. 253.5 hours for untreated infants (P=.0003).
- For influenza B, treated infants had a mean duration of 110.0 hours vs. 173.9 hours (P=.03).
- Oseltamivir treatment led to lower symptom scores and rapid viral load decline in nasopharyngeal secretions.
Conclusions:
- Oseltamivir treatment effectively reduces viral load and shortens symptom duration and severity in infants with influenza.
- The clinical effectiveness of oseltamivir appears more pronounced against influenza A than influenza B.
- Oseltamivir is a valuable therapeutic option for managing influenza in young infants.
Background:
Oseltamivir treatment is currently the only way of managing influenza in young infants for whom influenza vaccines are not licensed, but little data exist on the effectiveness of the treatment in this age group.
Methods:
In a prospective study, we enrolled 431 newborn infants and followed them up for 10 months during their first respiratory season (September 2017-June 2018). During each respiratory illness, we examined the infants and obtained nasopharyngeal specimens for determination of the viral etiology. Infants with influenza were re-examined at short intervals, and additional nasopharyngeal specimens were obtained at each visit for measuring the viral load. All infants with symptoms <48 hours received oseltamivir treatment. The parents filled out daily symptom diaries.
Results:
Among 23 infants with influenza A, the mean total duration of illness in oseltamivir recipients was 82.1 hours, compared with 253.5 hours in infants without treatment (P = .0003). For infants with influenza B, the corresponding durations were 110.0 and 173.9 hours, respectively (P = .03). In infants with influenza A, total symptom scores were significantly lower in oseltamivir-treated infants at all time points between days 3 and 11 after the onset of therapy. In most children with either influenza A or B, viral antigen concentrations declined rapidly within 1-2 days after the initiation of oseltamivir treatment.
Conclusions:
Oseltamivir treatment of infants with influenza rapidly decreased the viral load in nasopharyngeal secretions and shortened the duration and severity of symptoms. The clinical effectiveness of oseltamivir appeared to be greater against influenza A than against influenza B infections.
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