Infectious Diseases

August 4, 2022

Study tracks limited use of influenza antiviral therapy

A Vanderbilt study found that more than half of children diagnosed with influenza and deemed high risk for flu-related complications were given the recommended antiviral treatment.

More than half of children diagnosed with influenza and deemed high risk for flu-related complications were given the recommended antiviral treatment, according to data released from a recent study.

James Antoon, MD, PhD

According to the lead author, James Antoon, MD, PhD, assistant professor of Pediatrics at Monroe Carell Jr. Children’s Hospital at Vanderbilt, national organizations and treatment guidelines recommend the use of antivirals in all high-risk children and adolescents, regardless of how long they have had symptoms.

The multicenter study, “Guideline Concordant Antiviral Treatment in Children at High-risk for Influenza Complications,” was published in Clinical Infectious Diseases.

“We don’t know how often medical professionals follow these guidelines,” said Antoon. “We discovered that 4 in 10 children with a flu diagnosis and who are high risk for flu complications did not receive the antiviral therapy.

“This was alarming because treatment guidelines and national organizations like the CDC (Centers for Disease Control) and the AAP (American Academy of Pediatrics) both recommend the use of antiviral treatment for this patient population regardless of duration of symptoms.

“And with the focus of the COVID-19 pandemic, there is less attention on the resurgence of influenza. We hope that our findings will highlight the need to improve influenza treatment in our most vulnerable children.”

The retrospective, cross-sectional study used a Medicaid database called MarketScan to identify outpatient children between the ages 1-18 diagnosed with flu during 2016-2019 and at high risk for complications, which includes pneumonia, meningitis, hospitalization and death.

Findings highlighted several targeted areas for improvement including high-risk children ages 2 to 5 years old, those residing in a chronic care facility and those cared for in an emergency department setting.

“Influenza is a common and potentially life-threatening infection in children,” said Antoon. “We need to protect vulnerable children by both improving rates of influenza vaccination and treatments among those who fall sick with the flu.”

Antoon noted there are differing opinions among physicians and researchers concerning influenza antiviral use in children, Better studies are needed to determine the risk of uncommon side effects and of their effectiveness in certain pediatric populations.

The study group states that future studies are needed to evaluate the reasons why certain high-risk children are less likely to receive the recommended antiviral treatment.