Despite Recommendations for Influenza Antiviral Treatments, Use Remains Low and Variable Among Children

A new study in the December 2023 edition of Pediatrics (published online Nov. 13) shines light on the underutilization of influenza antiviral treatments in the pediatric outpatient setting. The study “Trends in Outpatient Influenza Antiviral Use Among Children and Adolescents in the United States” emphasizes wide variability and underuse. This conclusion came from a large, cross-sectional study that included more than 1.4 million unique antiviral dispensations between 2010 and 2019. There are four Food and Drug Administration- approved influenza antivirals including oral oseltamivir, inhaled zanamivir, oral baloxavir and intravenous peramivir. Among medications used in the outpatient setting, oseltamivir remains the only oral influenza antiviral that is FDA-approved for use in children under 5 years of age and is recommended for use in all age groups. The median age of children treated with antivirals was 9 years and antiviral dispensing was more common in boys and older children. Children with risk factors for influenza complications accounted for 63% of the antiviral dispensations. Treatment rates were highest in the East South-Central region and there was a substantial variation in antiviral dispensing by geographic region during the study period. Overall, less than two thirds of children with an influenza diagnosis received an antiviral. Despite widely endorsed national guidelines that all children under 2 years receive an antiviral, only 37% of children in this age group in the study with an influenza diagnosis were dispensed an antiviral. Authors of the study say care for children with influenza can be improved with judicious use of available antivirals, especially for children at high risk for influenza complications. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.