Effects of Oseltamivir on Influenza-Related Complications in Children With Chronic Medical Conditions

Piedra, Pedro A.; Schulman, Kathy L.; Blumentals, William A.

doi:10.1542/peds.2008-0977

Cited by 69 publications

(55 citation statements)

References 28 publications

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“…For non-BMT patients, advantages of early antiviral treatment are similar to those in healthy children [39]. Patients treated with oseltamivir had significant reductions in the risk for respiratory illnesses (other than pneumonia), otitis media, and hospitalization.…”

Section: Treatment Of Influenzamentioning

confidence: 84%

Protecting Pediatric Oncology Patients From Influenza

et al. 2013

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Influenza is a common respiratory pathogen. Its severity can be unpredictable, but people with chronic illness are at increased risk of severe infection, complications, and death from influenza. This review examines evidence to support various strategies to protect pediatric oncology patients from influenza-related morbidity. Influenza vaccination should be considered standard. Additional evidence-supported measures include antiviral treatment, antiviral prophylaxis, cohorting of patients, and hospital infection control measures. Data from other high-risk populations support the vaccination of family members, double-dose or high-dose vaccination, and the use of barrier methods. These measures have the potential to optimize patient outcomes because there will be fewer treatment interruptions for acute illness. These strategies can also protect patients from prolonged hospitalizations and morbidity related to influenza. The Oncologist 2013;18:204 -211 Implications for Practice: Pediatric oncology patients can have very severe infections with the influenza virus. Their vulnerability is due to chronic illness and immune suppression. Simple strategies, such as ensuring vaccination, infection control measures, and education regarding personal protection can protect this population that is susceptible to severe influenza.

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Section: Treatment Of Influenzamentioning

confidence: 84%

Protecting Pediatric Oncology Patients From Influenza

et al. 2013

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“…17 It is unknown whether oseltamivir may affect long-term complications such as superinfections and exacerbations of underlying conditions including asthma. [19][20][21] Data on readmissions for children hospitalized with infl uenza are limited. Such data may be helpful in planning for future epidemics and pandemics.…”

Section: Hospital Readmissions Among Children With H1n1 Infl Uenza Inmentioning

confidence: 99%

Hospital Readmissions Among Children With H1N1 Influenza Infection

Brogan

Hall

Sills

et al. 2014

Hospital Pediatrics

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Objectives: To describe readmissions among children hospitalized with H1N1 (influenza subtype, hemagglutinin1, neuraminidase 1) pandemic influenza and secondarily to determine the association of oseltamivir during index hospitalization with readmission. Methods: We reviewed data from 42 freestanding children’s hospitals contributing to the Pediatric Health Information System from May through December 2009 when H1N1 was the predominant influenza strain. Children were divided into 2 groups by whether they experienced complications of influenza during index hospitalization. Primary outcome was readmission at 3, 7, and 30 days among both patient groups. Secondary outcome was the association of oseltamivir treatment with readmission. Results: The study included 8899 children; 6162 patients had uncomplicated index hospitalization, of whom 3808 (61.8%) received oseltamivir during hospitalization, and 2737 children had complicated influenza, of whom 1055 (38.5%) received oseltamivir. Median 3-, 7-, and 30-day readmission rates were 1.6%, 2.5%, and 4.7% for patients with uncomplicated index hospitalizations and 4.3%, 5.8%, and 10.3% among patients with complicated influenza. The 30-day readmission rates did not differ by treatment group among patients with uncomplicated influenza; however, patients with complicated index hospitalizations who received oseltamivir had lower all-cause 30-day readmissions than untreated patients. The most common causes of readmission were pneumonia and asthma exacerbations. Conclusions: Oseltamivir use for hospitalized children did not decrease 30-day readmission rates in children after uncomplicated index hospitalization but was associated with a lower 30-day readmission rate among children with complicated infections during the 2009 H1N1 pandemic. Readmission rates for children who had complicated influenza infection during index hospitalizations are high.

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“…4,5 The traditional reference standard for the diagnosis of influenza A virus infection has been viral culture. However, the current reference standard for the diagnosis of influenza A, including H1N1 2009, is real-time reverse-transcriptase polymerase chain reaction (rRT-PCR).…”

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confidence: 99%

Performance of a Rapid Influenza Test in Children During the H1N1 2009 Influenza A Outbreak

Cruz

Demmler-Harrison

Caviness³

et al. 2010

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:Sensitivities of RIDTs have varied widely for the diagnosis of seasonal influenza. Few pediatric-specific data are available on RIDT performance for H1N1 2009 influenza A. WHAT THIS STUDY ADDS:To the best of our knowledge, this is the largest series reported to date of a comparison of RIDT performance to 2 reference standards, viral culture and rRT-PCR, for the detection of influenza A H1N1 2009 in respiratory specimens from pediatric patients. abstract OBJECTIVE: To evaluate the performance of a rapid influenza diagnostic test (RIDT) in detecting H1N1 2009 influenza A virus in respiratory samples from pediatric patients in comparison to that of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) and viral culture.METHODOLOGY. This was a cross-sectional diagnostic-accuracy study conducted at a tertiary care children's hospital. Patients for whom the RIDT (BinaxNOW [Binax, Inc, Portland, ME]), viral culture, and rRT-PCR results were known were included. Sensitivity, specificity, and likelihood ratios (LRs) were calculated. RESULTS:A total of 3030 specimens had RIDT results paired with both rRT-PCR and viral culture results. With rRT-PCR as the reference, overall test sensitivity was 45% (95% confidence interval [CI]: 43.3%-46.3%) and specificity was 98.6% (95% CI: 98.1%-99%). Positive and negative LRs were 32.9 (95% CI: 22.9 -45.4) and 0.56 (95% CI: 0.54 -0.58), respectively. RIDT sensitivity was significantly higher in young infants and children younger than 2 years than in older children. Using viral culture as the reference standard, RIDT sensitivity was 55.5% (95% CI: 51.9%-95.6%) and specificity was 95.6% (95% CI: 95%-96.1%). The positive and negative LRs were 12.6 and 0.47, respectively. CONCLUSIONS:The RIDT had relatively poor sensitivity but excellent specificity in this consecutive series of respiratory specimens obtained from pediatric patients. Although a positive RIDT result was highly accurate in predicting infection with influenza type A H1N1 2009 in children, a negative RIDT result did not preclude a child having H1N1. Therefore, for children at high risk with influenza-like illnesses during high-prevalence periods of influenza, empiric initiation of antiviral therapy should be considered for patients with a negative RIDT result. Commercially available rapid influenza diagnostic tests (RIDTs) offer the advantages of low cost, ease of use, and rapid turnaround time. 6 The RIDTs also have shown consistently high specificity for both seasonal (92%-100%) and H1N1 2009 (86%-100%) influenza A virus detection. [6][7][8][9][10][11][12][13][14][15] However, the sensitivity of these assays has varied considerably for both seasonal influenza viruses (49%-95%) 6-10 and H1N1 2009 influenza A (10%-53%). [11][12][13][14][15] Furthermore, few data exist on the performance of RIDTs for detection of influenza A H1N1 2009 in children, with sensitivities ranging from 42% to 74%, 16,17 and few data exist on the performance of these assays in clinical settings. We present her...

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Effects of Oseltamivir on Influenza-Related Complications in Children With Chronic Medical Conditions

Abstract: When it was prescribed at influenza diagnosis, oseltamivir was associated with reduced risks of influenza-related complications and hospitalizations for children and adolescents at high risk of influenza complications.

Cited by 69 publications

References 28 publications

Protecting Pediatric Oncology Patients From Influenza

Protecting Pediatric Oncology Patients From Influenza

Hospital Readmissions Among Children With H1N1 Influenza Infection

Performance of a Rapid Influenza Test in Children During the H1N1 2009 Influenza A Outbreak

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