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Neuraminidase inhibitors increased survival in children with influenza
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Neuraminidase inhibitors can help improve survival of children who are critically ill with influenza, according to recent study results published in Pediatrics.
Janice K. Louie, MD, MPH, of the California Department of Public Health and colleagues evaluated data from 784 children aged 0 to 17 years hospitalized in an ICU for influenza from April 3, 2009 to Sep. 30, 2012 to determine neuraminidase inhibitors (NAIs) improve survival in critically ill children.
During the 2009 H1N1 pandemic, 90% of cases were treated with NAIs compared with 63% in the post-pandemic period (P<.0001). Overall, 83% of patients were treated with NAIs.
Six percent of 653 patients treated with NAIs died compared with 8% of 131 untreated patients (OR=0.67; 95% CI, 0.34-1.36).
In a statistical multivariate model that accounted other factors that can contribute to severity of illness, including presence of chronic medical conditions, diagnosis of pneumonia, need for mechanical ventilation and secondary bacterial infection, those treated with NAIs also had a reduced risk of death compared with those untreated (OR=0.36; 95% CI, 0.16-0.83). Survival was significantly associated with treatment that within 48 hours of illness onset (P=.04).
"Clinicians should be thinking of influenza when they see a child with severe respiratory illness, especially when influenza is circulating in the community,” Louie told Infectious Diseases in Children. "In these situations clinicians are encouraged to test for influenza, and initiate antiviral treatment as soon as possible while awaiting test results." — Amber Cox
Janice K. Louie, MD, MPH, can be reached at CDPH, 850 Marina Bay Parkway, Richmond, CA 94804; email: janice.louie@cdph.ca.gov.
Disclosure: The study was funded in part by the California Department of Public Health.
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