Oseltamivir May Shorten Hospital Stays for Children With the Flu

Treatment with oseltamivir (Tamiflu; Genentech) was well tolerated in children with the influenza (flu), and investigators reported no deaths in the study. However, the duration of hospitalizations for patients with a fever after the drug was administered was significantly longer for patients infected with either A(H1N1) or A(H3N2), according to the study data.¹

Flu, Influenza, Pediatric, Hospitalization | Image Credit: Alexis Scholtz/peopleimages.com | stock.adobe.com

As of September 13, 2024, there were 199 pediatric deaths related to the 2023 to 2024 season, which ties with the record high of pediatric deaths during the 2019 to 2020 season. Of the 158 children that were eligible for a vaccination, 83% were not fully vaccinated.

The CDC identified that vaccination has been shown to reduce the severity of illness for individuals. Further, the agency states that children younger than 5 or children with certain underlying conditions have an increased risk of developing serious flu-related complications. Current recommendations state that patients 6 months and older should get an annual flu vaccination.²

In the current study, investigators assessed the clinical efficacy and tolerability of oseltamivir in children who have not received vaccination and had various infections in 2 consecutive flu seasons in Romania. The study was observational in nature and consisted of a single center. Investigators included individuals less than 18 years of age who were infected with flu A or B and required hospitalization between October 1, 2022, to May 30, 2023, and October 1, 2023, and May 4, 2024. Information on demographics, comorbidities, medications, symptoms, and signs of disease were used for the study. The main comorbidities examined were being overweight or class 1 obesity, dermatological diseases, blood diseases, asthma and chronic respiratory illnesses, and renal and gastrointestinal diseases. Oseltamivir was administered orally, twice daily, for 5 days at 75 mg/day. The time to onset fever, administration of oseltamivir, and resolution of fever were also recorded.¹

A total of 1300 individual were enrolled that met the inclusion criteria. Of the group hospitalized in 2022 to 2023 (n = 791), approximately 89% had flu A with 86.4% having subtype A(H1N1)pdm09 and 13.6% having subtype A(H3N2). The median age was 2.4 years and 59% were male. Of patients in the 2023 to 2024 season (n = 509), 81% had flu A with 83.4% having subtype A(H1N1)pdm09 and 16.6% having A(H3N2).¹

Investigators found that children with obesity, asthma, and gastrointestinal disease had longer durations of stays at 7 days, 9 days, and 5 days, respectively, compared with children without comorbidities at 4 days. Furthermore, children aged 5 and older were more likely to be admitted to the hospital if they suffered from obesity, and patients aged 5 to 14 years were more likely to be admitted if they had asthma. Patients aged 2 to 4 were more likely to be admitted if they had a gastrointestinal disease.¹

Investigators found that hospitalization stays were shorter for those treated with oseltamivir in the 2023 to 2024 season for patients with asthma than in the 2022 to 2023 season. The treatment administration was not interrupted by adverse events, with 9% experiencing diarrhea and 11% experiencing nausea, according to the investigators.¹

REFERENCES

1. Jugulete G, Olariu MC, Stanescu R, et al. The Clinical Effectiveness and Tolerability of Oseltamivir in Unvaccinated Pediatric Influenza Patients during Two Influenza Seasons after the COVID-19 Pandemic: The Impact of Comorbidities on Hospitalization for Influenza in Children. Viruses. 2024;16(10):1576. Published 2024 Oct 7. doi:10.3390/v16101576

2. CDC. Flu Deaths in Children Last Season Reach 199, Matching Record. September 13, 2024. Accessed November 19, 2024. https://www.cdc.gov/flu/whats-new/2023-2024-flu-deaths-children.html

3. Sur M, Lopez MJ, Patel P, et al. Oseltamivir. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Accessed November 19, 2024. https://www.ncbi.nlm.nih.gov/books/NBK539909/