In a global study of more than 1.4 million outpatient and emergency department prescription claims for children between 2010 and 2019, as presented in Pediatrics, researchers found there is wide variability in prescribing as well as underuse of influenza antivirals for children. Kids were most commonly seen in outpatient office visits and urgent care settings. 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. Additionally, the data revealed that treatment rates were highest among older children from 12 to 17 years old. In their discussion, the researchers note: “The low rate of antiviral use in young children in this study, along with recent evidence of low guideline-concordant antiviral treatment in children at a high risk of influenza complications, highlights the need for improved influenza management in the most vulnerable children in the United States.”
Room for improvement: The authors suggest that antiviral prescribing could be a logical area of care improvement for those treating children with influenza. The Centers for Disease Control and Prevention recommends antiviral treatment in children age 2 and under as a way to reduce the risk of complications, such as otitis media, pneumonia, and hospitalization.