Comprehensive Summary
This study by Walsh et al. investigates the impact of early administration of oseltamivir on outcomes in pediatric patients hospitalized with influenza. Conducted across 36 centers with a cohort of 55,799 children, the research utilized a propensity score-weighted retrospective analysis. Early use of oseltamivir was defined as administration on hospital day 0 or 1. Improved outcomes were measured by reduced readmission rates, and lower incidences of late ICU transfer, in-hospital mortality, and ECMO use. Results indicated that early oseltamivir administration was associated with a median hospital stay reduction of one day and lower rates of 7-day readmittance, late ICU transfer, and in-hospital mortality or ECMO use by 1.3%, 3%, and 0.9%, respectively. Inverse probability treatment weighting analyses confirmed these findings, although no strong association was found in high-risk subgroups for in-hospital death or ECMO use.
Outcomes and Implications
The findings underscore the potential benefits of early oseltamivir administration in hospitalized pediatric patients with influenza, aligning with recommendations from the American Academy of Pediatrics and the Infectious Diseases Society of America. Despite these recommendations, the study highlights a gap in the early use of oseltamivir, possibly due to a lack of robust inpatient-focused literature. The large dataset and efforts to control confounding variables provide compelling evidence supporting early treatment, which could lead to policy changes and improved clinical practices in pediatric care settings.