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Variability Seen in Use of Influenza Antiviral Agents in Children

Guideline-concordant antiviral use low for young children at high risk for influenza complications

By Elana Gotkine HealthDay Reporter

MONDAY, Nov. 13, 2023 (HealthDay News) — Considerable variability is seen in the use of influenza antiviral agents in children, with low use among young children at high risk for complications, according to a study published online Nov. 13 in Pediatrics.

James W. Antoon, M.D., Ph.D., M.P.H., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted a cross-sectional study of outpatient and emergency department prescription claims in individuals younger than 18 years. The rate of antiviral dispensing per 1,000 enrolled children was examined as the primary outcome.

A total of 1,416,764 unique antiviral dispensings between 2010 and 2019 were included in the analysis. The researchers found that the most frequently prescribed antiviral was oseltamivir (99.8 percent). The rate of dispensing varied from 4.4 to 48.6 per 1,000 enrolled children. The highest treatment rates were seen for older children (12 to 17 years), during the 2017 to 2018 influenza season, and in the East South Central region. Among young children (younger than 2 years of age) at a high risk for influenza complications, guideline-concordant antiviral use was low (<40 percent). For prescriptions, the inflation-adjusted cost was $208,458,979, and the median cost varied from $111 to $151.

“Although we must improve influenza vaccination rates, antiviral agents also must play a larger role in the prophylaxis and treatment of influenza infection,” Pia S. Pannaraj, M.D., M.P.H., from the University of California in San Diego, writes in an accompanying editorial. “When it comes to influenza, we should be using all the tools in our toolbox.”

One author disclosed ties to Merck, and a second disclosed ties to Biomerieux.

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