Association Between Oseltamivir Timing and Clinical Outcomes in Hospitalized Children with Influenza: A Retrospective
Hassan S Albohassan1, Nadia Jradi2, Aida Al Jabri1
1Pediatric Department, Almoosa Specialist Hospital, Alahsa, Saudi Arabia.
Background:
Influenza is one of the most common viruses causing an acute course illness, mainly targeting the respiratory system. It is a communicable disease that spreads easily between individuals and is usually self-limiting in most cases. However, complications of influenza are numerous, including secondary bacterial infections, exacerbation of underlying respiratory conditions, and central nervous system-related complications. The risk of influenza-related hospitalization and complications is increased in children younger than 5 years and in those with underlying chronic diseases. Three classes of antiviral therapy are used in the treatment of influenza: neuraminidase inhibitors, adamantanes, and inhibitors of influenza cap-dependent endonuclease. Oseltamivir is considered the mainstay therapy for influenza treatment.
Objective:
This study investigates the efficacy of early oseltamivir treatment compared to late treatment in improving recovery by reducing hospital length of stay and preventing influenza-related complications such as pneumonia, otitis media, and asthma exacerbations.
Methodology:
This retrospective study analyzed data from 280 pediatric patients admitted to a tertiary care hospital between January 2020 and April 2023. Included patients were aged 1 month to 14 years, had laboratory-confirmed influenza A or B by polymerase chain reaction or point-of-care rapid testing, and received oseltamivir during hospitalization. Early oseltamivir treatment was defined as initiation within 48 hours of symptom onset, whereas initiation after 48 hours was considered late.
Results:
The study included 151 (53.9%) males and 129 (46.1%) females. Children who received early oseltamivir treatment had a significantly shorter hospital length of stay of approximately one day (∼16-19 hours) compared to those who started treatment after 48 hours [mean ± SD: 3.28 ± 1.46 vs 3.95 ± 2.26 days; P = 0.007]. A weak positive correlation was observed between time to oseltamivir initiation and hospital length of stay (r = 0.13, P = 0.02). Early treatment was associated with a significantly lower incidence of pneumonia, otitis media, and acute asthma exacerbation compared to late treatment (P < 0.05 for all).
Conclusion:
Early initiation of oseltamivir within 48 hours is effective in reducing hospital length of stay and preventing common influenza-related complications.
Insights
Early oseltamivir treatment for influenza in children, initiated within 48 hours of symptom onset, significantly reduces hospital stays. This timely intervention also prevents common complications like pneumonia and otitis media.
Area of Science:
- Pediatric Infectious Diseases
- Antiviral Therapy Research
- Respiratory Illness Management
Background:
- Influenza is a common respiratory illness with potential severe complications, especially in children.
- Oseltamivir is a primary antiviral medication for influenza treatment.
- Timely administration of antiviral therapy is crucial for managing influenza outcomes.
Purpose of the Study:
- To evaluate the impact of early versus late oseltamivir treatment on pediatric influenza recovery.
- To assess the effect of treatment timing on hospital length of stay and complication rates.
Main Methods:
- Retrospective analysis of 280 pediatric patients with confirmed influenza A or B.
- Comparison of outcomes between patients receiving oseltamivir within 48 hours (early) and after 48 hours (late) of symptom onset.
- Data collected on hospital length of stay and incidence of pneumonia, otitis media, and asthma exacerbations.
Main Results:
- Early oseltamivir treatment (within 48 hours) resulted in a significantly shorter hospital stay (approximately one day shorter).
- A weak positive correlation was found between delayed treatment initiation and increased hospital length of stay.
- Patients receiving early treatment had a significantly lower incidence of pneumonia, otitis media, and asthma exacerbations.
Conclusions:
- Initiating oseltamivir treatment within 48 hours of symptom onset is effective in pediatric influenza cases.
- Early treatment reduces hospital length of stay and prevents key influenza-related complications.
- This supports prompt antiviral therapy for improving pediatric influenza management.
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