tetano
Editor, Senior Moderator
Clin Infect Dis
. 2024 Dec 17:ciae573.
doi: 10.1093/cid/ciae573. Online ahead of print. Antiviral Use Among Children Hospitalized With Laboratory-Confirmed Influenza Illness: A Prospective, Multicenter Surveillance Study
James W Antoon[SUP] 1 [/SUP], Justin Z Amarin[SUP] 1 2 [/SUP], Olla Hamdan[SUP] 1 [/SUP], Tess Stopczynski[SUP] 1 [/SUP], Laura S Stewart[SUP] 1 [/SUP], Marian G Michaels[SUP] 3 [/SUP], John V Williams[SUP] 3 4 [/SUP], Eileen J Klein[SUP] 5 [/SUP], Janet A Englund[SUP] 5 [/SUP], Geoffrey A Weinberg[SUP] 6 [/SUP], Peter G Szilagyi[SUP] 6 7 [/SUP], Jennifer E Schuster[SUP] 8 [/SUP], Rangaraj Selvarangan[SUP] 8 [/SUP], Christopher J Harrison[SUP] 8 [/SUP], Julie A Boom[SUP] 9 [/SUP], Leila C Sahni[SUP] 9 [/SUP], Flor M Muñoz[SUP] 9 [/SUP], Mary Allen Staat[SUP] 10 [/SUP], Elizabeth P Schlaudecker[SUP] 10 [/SUP], James D Chappell[SUP] 1 [/SUP], Benjamin R Clopper[SUP] 11 [/SUP], Heidi L Moline[SUP] 11 [/SUP], Angela P Campbell[SUP] 11 [/SUP], Andrew J Spieker[SUP] 1 [/SUP], Samantha M Olson[SUP] 12 [/SUP], Natasha B Halasa[SUP] 1 [/SUP]
Affiliations
Background: Guidelines state that all hospitalized children with suspected or confirmed influenza receive prompt treatment with influenza-specific antivirals. We sought to determine the frequency of, and factors associated with, antiviral receipt among hospitalized children.
Methods: We conducted active surveillance of children presenting with fever or respiratory symptoms from 1 December 2016 to 31 March 2020 at 7 pediatric medical centers in the New Vaccine Surveillance Network. The cohort consisted of children hospitalized with influenza A or B confirmed by clinical or research testing. The primary outcome was frequency of antiviral receipt during hospitalization. We used logistic regression to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for factors associated with antiviral receipt.
Results: A total of 1213 children with laboratory-confirmed influenza were included. Overall, 652 children (53.8%) received an antiviral. Roughly 63.0% of children received clinical influenza testing. Among those with clinical testing, 67.4% received an antiviral. Factors associated with higher odds of antiviral receipt included hematologic (aOR = 1.76; 95% CI = 1.03-3.02) or oncologic/immunocompromising (aOR = 2.41; 95% CI = 1.13-5.11) disorders, prehospitalization antiviral receipt (aOR = 2.34; 95% CI = 1.49-3.67), clinical influenza testing (aOR = 3.07; 95% CI = 2.28-4.14), and intensive care unit admission (aOR = 1.53; 95% CI = 1.02-2.29). Symptom duration >2 days was associated with lower odds of antiviral treatment (aOR = 0.40; 95% CI = .30-.52). Antiviral receipt varied by site with a 5-fold difference across sites.
Conclusions: Almost half of children hospitalized with influenza did not receive antivirals. Additional efforts to understand barriers to guideline adherence are crucial for optimizing care in children hospitalized with influenza.
Keywords: antivirals; guideline-concordant; influenza; oseltamivir; pediatrics.
. 2024 Dec 17:ciae573.
doi: 10.1093/cid/ciae573. Online ahead of print. Antiviral Use Among Children Hospitalized With Laboratory-Confirmed Influenza Illness: A Prospective, Multicenter Surveillance Study
James W Antoon[SUP] 1 [/SUP], Justin Z Amarin[SUP] 1 2 [/SUP], Olla Hamdan[SUP] 1 [/SUP], Tess Stopczynski[SUP] 1 [/SUP], Laura S Stewart[SUP] 1 [/SUP], Marian G Michaels[SUP] 3 [/SUP], John V Williams[SUP] 3 4 [/SUP], Eileen J Klein[SUP] 5 [/SUP], Janet A Englund[SUP] 5 [/SUP], Geoffrey A Weinberg[SUP] 6 [/SUP], Peter G Szilagyi[SUP] 6 7 [/SUP], Jennifer E Schuster[SUP] 8 [/SUP], Rangaraj Selvarangan[SUP] 8 [/SUP], Christopher J Harrison[SUP] 8 [/SUP], Julie A Boom[SUP] 9 [/SUP], Leila C Sahni[SUP] 9 [/SUP], Flor M Muñoz[SUP] 9 [/SUP], Mary Allen Staat[SUP] 10 [/SUP], Elizabeth P Schlaudecker[SUP] 10 [/SUP], James D Chappell[SUP] 1 [/SUP], Benjamin R Clopper[SUP] 11 [/SUP], Heidi L Moline[SUP] 11 [/SUP], Angela P Campbell[SUP] 11 [/SUP], Andrew J Spieker[SUP] 1 [/SUP], Samantha M Olson[SUP] 12 [/SUP], Natasha B Halasa[SUP] 1 [/SUP]
Affiliations
- PMID: 39688383
- DOI: 10.1093/cid/ciae573
Background: Guidelines state that all hospitalized children with suspected or confirmed influenza receive prompt treatment with influenza-specific antivirals. We sought to determine the frequency of, and factors associated with, antiviral receipt among hospitalized children.
Methods: We conducted active surveillance of children presenting with fever or respiratory symptoms from 1 December 2016 to 31 March 2020 at 7 pediatric medical centers in the New Vaccine Surveillance Network. The cohort consisted of children hospitalized with influenza A or B confirmed by clinical or research testing. The primary outcome was frequency of antiviral receipt during hospitalization. We used logistic regression to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for factors associated with antiviral receipt.
Results: A total of 1213 children with laboratory-confirmed influenza were included. Overall, 652 children (53.8%) received an antiviral. Roughly 63.0% of children received clinical influenza testing. Among those with clinical testing, 67.4% received an antiviral. Factors associated with higher odds of antiviral receipt included hematologic (aOR = 1.76; 95% CI = 1.03-3.02) or oncologic/immunocompromising (aOR = 2.41; 95% CI = 1.13-5.11) disorders, prehospitalization antiviral receipt (aOR = 2.34; 95% CI = 1.49-3.67), clinical influenza testing (aOR = 3.07; 95% CI = 2.28-4.14), and intensive care unit admission (aOR = 1.53; 95% CI = 1.02-2.29). Symptom duration >2 days was associated with lower odds of antiviral treatment (aOR = 0.40; 95% CI = .30-.52). Antiviral receipt varied by site with a 5-fold difference across sites.
Conclusions: Almost half of children hospitalized with influenza did not receive antivirals. Additional efforts to understand barriers to guideline adherence are crucial for optimizing care in children hospitalized with influenza.
Keywords: antivirals; guideline-concordant; influenza; oseltamivir; pediatrics.