Document Type

Article

Publication Date

6-2025

Identifier

DOI: 10.1111/irv.70124; PMCID: PMC12152273

Abstract

BACKGROUND: Influenza contributes to a high burden of pediatric emergency department (ED) visits annually. Guidelines recommend outpatient antiviral treatment for children at higher risk of severe influenza and recommend considering treatment for those who present within 2 days of symptom onset. We describe antiviral prescription in children with influenza presenting to the ED.

METHODS: We analyzed data from the New Vaccine Surveillance Network (2016-2020), including children presenting to the ED and enrolled with confirmed influenza at one of seven pediatric academic centers. We compared characteristics of children prescribed antivirals to those who were not, using generalized estimating equations models to identify predictors of antiviral prescription. Children were considered at higher risk of severe influenza if they were <  5 years old or had an underlying condition.

RESULTS: Overall, 2472 (15%) of 16,915 enrolled children tested positive for influenza virus. Among these, 1931 (78%) were at higher risk of severe influenza; only 622 (32%) received an antiviral. Among 233 (9%) children not at high risk with symptom onset ≤ 2 days, 62 (27%) were prescribed an antiviral. Children prescribed an antiviral had a shorter duration of illness prior to presenting to the ED. For children at higher risk of severe influenza, odds of antiviral prescription were higher for those clinically tested for influenza and with underlying conditions.

CONCLUSION: Clinical testing and having an underlying condition were associated with antiviral prescription in children at higher risk of severe influenza. However, only 1/3 of those at higher risk were prescribed an antiviral. Strategies to increase antiviral use for children at higher risk for influenza in the ED are needed.

Journal Title

Influenza Other Respir Viruses

Volume

19

Issue

6

First Page

70124

Last Page

70124

MeSH Keywords

Humans; Influenza, Human; Emergency Service, Hospital; Child, Preschool; Male; Female; Infant; Antiviral Agents; Child; United States; Adolescent; Influenza Vaccines; Infant, Newborn

PubMed ID

40495453

Keywords

antivirals; influenza; pediatrics

Comments

Grants and funding

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://onlinelibrary.wiley.com/doi/10.1111/irv.70124

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