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Tamiflu use rises in Colorado pediatric hospital after 2009 pandemic
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Recent findings published in Hospital Pediatrics showed that the use of the antiviral drug Tamiflu continued to rise among hospitalized children after the 2009 H1N1 influenza pandemic.
“Our findings provide insight into oseltamivir [(Tamiflu, Roche)] prescribing practices for hospitalized children in both the ICU and non-ICU settings, as well as the impact of national guidelines in influencing physician practice changes,” Joshua T.B. Williams, MD, of the department of pediatrics, University of Colorado School of Medicine, and colleagues wrote. “Our findings suggest that among a multitude of factors that influence prescribing, illness severity and duration of symptoms are leading considerations.”
Before the 2009 H1N1 influenza pandemic, there was significant variation in reported prescribing of oseltamivir, with rates as low as 2% and as high as 48%, the researchers wrote. In 2009, the FDA authorized emergency use of oseltamivir to treat children aged younger than 1 year and expanded prescribing guidelines to include neonates after 2009.
To report the rate of oseltamivir use and to identify factors associated with its use, the researchers performed a retrospective cohort study of 395 patients from 2010 to 2014 at Children’s Hospital Colorado.
Eighty-two percent of patients received oseltamivir, according to study data, and it was associated with ICU admission, longer lengths of stay, admission within 48 hours of symptom onset and influenza A H1N1 infection (P < .05 for all) in univariate analysis.
Oseltamivir use reached a high of 97% during the 2013-2014 season, exceeding the 87% rate during the 2009 pandemic season, the researchers wrote. They noted that its use declined for the 2011-2012 season, which they considered a milder influenza season.
The researchers cited expanded FDA and AAP guidelines and the release of beneficial studies as reasons for the increased usage of oseltamivir.
“These increasing prescribing trends align with pediatric governing body recommendations and are of interest in the setting of conflicting evidence in the literature regarding its morbidity and mortality benefits,” Williams and colleagues wrote. “Additional studies are needed to confirm these findings in a broader context.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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