In practice, just under half of pediatricians (49.5%) follow national recommendations from the American Academy of Pediatrics (AAP) for use of the antiviral oseltamivir for children hospitalized with influenza, according to survey results published in Pediatrics. The survey polled 787 physicians from 5 specialties among 7 children’s hospitals in the United States from March 2024 to June 2024. AAP recommends that all children hospitalized for flu receive oseltamivir. Knowing about AAP recommendations increased the pediatricians’ likelihood of recommending oseltamivir, although these same respondents did not recommend oseltamivir in 38% of cases. The reason, the authors suggest, could be that clinicians are not always convinced of the benefit and could be influenced if more trial data supported the recommendations.
Similar trends in outpatient prescribing: A separate global study in Pediatrics published in late 2023 found there is wide variability in prescribing as well as underuse of influenza antivirals for children in outpatient offices and urgent care settings. Dispensing rates per season ranged from 4.4 to 48.6 per 1,000. Oseltamivir was the most frequently prescribed antiviral (99.8%), which makes sense because it’s the only oral influenza antiviral approved by the FDA for use in children age 5 and younger in the outpatient setting. Zanamivir and baloxavir were the next most preferred treatments of choice.