Oseltamivir delivers modest clinical advantages to children with influenza when started within 48 hours of symptom beginning. Nevertheless, effectiveness and safety stay controversial. We conducted the current meta-analysis using a comprehensive search of EMBASE, MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials till 15 February 2018 for randomized controlled trials of oseltamivir therapy in children. Four studies met the search criteria. Overall, oseltamivir treatment significantly reduced the duration of illness in the ITTI population (RMST difference, -18.2 hours; 95% CI, −32.2 to −0.6 hours). In trials that enrolled patients without asthma, the difference was larger (RMST difference −26.7 hours; 95% CI, −49.8 to −6.1 hours).Risk of otitis media was 34% lower in the ITTI population. Vomiting was the only adverse event with a significantly higher risk in the treatment group. Regardless of considerable heterogeneity in pediatric trials, we found that treatment with oseltamivir treatment started within 24 hours of symptom onset provides substantial benefits to children with influenza infection and lowered the risk of developing otitis media.
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