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J Pediatric Infect Dis Soc . Factors associated with non-prescription of oseltamivir for infant influenza over nine seasons

tetano

Editor, Senior Moderator
J Pediatric Infect Dis Soc


. 2024 Jul 31:piae075.
doi: 10.1093/jpids/piae075. Online ahead of print. Factors associated with non-prescription of oseltamivir for infant influenza over nine seasons

Haniah A Zaheer[SUP] 1 2 [/SUP], Krissy Moehling Geffel[SUP] 3 [/SUP], Sarah Chamseddine[SUP] 2 [/SUP], Hui Liu[SUP] 2 [/SUP], John V Williams[SUP] 2 [/SUP], Judith M Martin[SUP] 2 [/SUP], Anne-Marie Rick[SUP] 2 [/SUP]



Affiliations
Abstract

Background/objective: The Centers for Disease Control and Prevention (CDC) recommends oseltamivir phosphate for children <2 years old with confirmed or suspected influenza as they are at high risk for complications. We analyzed infant characteristics associated with non-prescription of oseltamivir over nine years.
Methods: We conducted a retrospective electronic health record (EHR) review of infants <12 months old born between January 1, 2012 and December 31, 2019 within the UPMC health system in Southwestern Pennsylvania who had >2 well-child visits during their first year. Infants with a confirmed positive test for influenza were included in the analysis. Factors associated with infant oseltamivir non-prescription were assessed using multivariable logistic regression.
Results: Of 457 infants with confirmed influenza, 86% were prescribed oseltamivir. The proportion of infants prescribed oseltamivir increased from an average of 64.6% during 2012-2016 influenza seasons to 90.4% during 2016-2020 influenza seasons. Infants were more likely to not be prescribed oseltamivir if they experienced >2 days of influenza symptoms (OR: 9.4, 95% CI: 4.8, 18.7, P< 0.001), were diagnosed during the 2012-2016 influenza seasons (OR: 4.2, 95% CI: 1.8, 9.5, P<0.001), tested positive for influenza via a multiplex/RT-PCR test (OR: 6.7, 95% CI: 2.7, 16.3, P<0.001; OR: 2.7, 95% CI: 1.1, 7.1; P=0.04), or did not have a fever at point-of-care (OR: 2.3, 95% CI: 1.2, 4.6, P=0.01).
Conclusion: Adherence to CDC influenza antiviral treatment guidelines for infants is high and improved over time. However, provision of targeted education to providers may further improve oseltamivir prescribing practices for high-risk children <12 months of age.


 
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