Although national medical guidelines advocate for antiviral treatments for young children diagnosed with influenza, a recent study indicates that such treatments are not being adequately utilized.
The study titled “Antiviral Use Among Children Hospitalized with Laboratory-Confirmed Influenza Illness: A Prospective, Multicenter Surveillance Study” has been published in Clinical Infectious Diseases, the leading journal of the Infectious Diseases Society of America.
During the winter months in the United States, influenza accounts for approximately 10% of pediatric hospital admissions.
Despite existing guidelines that recommend all hospitalized children with suspected or confirmed influenza receive immediate antiviral treatment, regardless of how long they’ve had symptoms or their vaccination status, the study reveals a significant gap in compliance with these recommendations.
“Our results regarding the limited administration of antivirals to hospitalized children with influenza are troubling,” stated James Antoon, MD, PhD, MPH, an assistant professor of Pediatrics at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “We discovered that nearly half of the children hospitalized for flu did not receive antiviral medications, despite strong recommendations from the Centers for Disease Control (CDC), the Infectious Diseases Society of America, and the American Academy of Pediatrics. These antivirals are essential in reducing symptom duration and preventing complications from influenza.”
Antoon, alongside Justin Amarin, MD, co-directed a multicenter analysis of children diagnosed with influenza at seven pediatric medical centers as part of the CDC’s New Vaccine Surveillance Network (NVSN) between December 1, 2016, and March 31, 2020. The study included 1,213 children with laboratory-confirmed influenza.
Of the children tested for influenza through research or clinical methods, only about 50% received antiviral treatment. However, among those who underwent clinical testing by a physician, nearly two-thirds were given an antiviral.
Additionally, nearly 37% of hospitalized infants under 6 months of age, who cannot be vaccinated against the flu, did not receive antiviral medications.
“The inadequate use of antiviral treatments highlights the necessity for further investigation into the obstacles to treatment and the need for enhanced clinical testing. Optimizing antiviral treatment is crucial for improving care for this group of young patients,” added Antoon.
Natasha Halasa, MD, PhD, the Craig Weaver Professor of Pediatrics in the Division of Pediatric Infectious Diseases at Monroe Carell, was the principal investigator at the site.
“Data from two national influenza surveillance networks reveal a decline in antiviral treatment for hospitalized children and adolescents with influenza, dropping from 70%-86% during the 2017-2018 season to below 60% in 2023-2024,” highlighted Halasa.
“Furthermore, only 30% of children and adolescents at higher risk for influenza-related complications received antiviral prescriptions during outpatient visits.”
Halasa’s findings were released in the CDC publication Morbidity and Mortality Weekly Report (MMWR) on November 14.
According to Antoon, antiviral treatments lead to shorter symptom duration, decreased likelihood of subsequent pneumonia, sinusitis, and otitis media. Some evidence indicates that the use of antivirals may shorten hospital stays and reduce the need for mechanical ventilation or intensive care unit admissions.
“Future research should prioritize enhancing influenza testing and ensuring timely antiviral treatments for children hospitalized with influenza, as well as establishing standardized care practices both within and across medical facilities,” he concluded.