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On November 14, 2022, we reviewed a cohort study published in JAMA Pediatrics that examined whether early oseltamivir use is associated with improved outcomes in children hospitalized with influenza.
A multicenter retrospective study of 55 799 children who were hospitalized with influenza from October 1, 2007, to March 31, 2020, in 36 tertiary care pediatric hospitals assessed the effects of early oseltamivir treatment, defined for the purpose of the study as use of oseltamivir on hospital days 0 or 1. The primary outcome was hospital length of stay (LOS) in calendar days and secondary outcomes included 7-day hospital readmission, late intensive care unit (ICU) transfer (ie, transferred on or after hospital day 2), and a composite outcome of in-hospital death or use of extracorporeal membrane oxygenation (ECMO).
In propensity score–weighted models, researchers found that children treated with early oseltamivir had reduced LOS (median, 3 vs 4 days; IPTW model ratio, 0.52; 95% CI, 0.52-0.53), all-cause 7-day hospital readmissions (3.5% vs 4.8%; adjusted odds ratio [aOR], 0.72; 95% CI, 0.66-0.77), late ICU transfer (2.4% vs 5.5%; aOR, 0.41; 95% CI, 0.37-0.46), and the composite outcome of death or ECMO use (0.9% vs 1.4%; aOR, 0.63; 95% CI, 0.54-0.73) compared to participants who did receive early oseltamivir treatment.
"These data support current recommendations for early initiation of oseltamivir in children hospitalized with influenza."