TOPLINE

In children hospitalized with laboratory-confirmed influenza, oseltamivir treatment was associated with a reduced risk for ICU admissions and shorter hospital stays compared with no treatment.

METHODOLOGY

• In a retrospective cohort study, researchers analyzed data from a US population-based surveillance network across 13 states to assess the effect of oseltamivir treatment among children hospitalized with influenza.
• They covered data for influenza seasons between 2014-2015 and 2022-2023, excluding 2020-2021.
• The primary outcome was ICU admission, and the secondary outcome was hospital length of stay.
• The primary ICU admission analysis included 6044 children younger than 18 years with laboratory-confirmed influenza and available dates of respiratory symptom onset, of whom 70.2% received oseltamivir. The secondary analysis of hospital length of stay included 7103 children (median age, 3 years; 56% boys), of whom 80.9% received oseltamivir.

TAKEAWAY

• Oseltamivir treatment was associated with a reduced risk for ICU admissions compared with no treatment (adjusted hazard ratio [aHR], 0.69; 95% CI, 0.60-0.80).
• Oseltamivir treatment was associated with a shortened hospital stay compared with no treatment (aHR for discharge, 1.13; 95% CI, 1.06-1.21).
• Both early oseltamivir initiation (within 2 days of the onset of respiratory symptoms) and late initiation (3 days or more after symptom onset) were associated with a reduced risk for ICU admissions compared with no treatment (aHR, 0.74 and 0.55, respectively; both P < .001).
• Children who received early oseltamivir treatment had shorter hospital stays than those who did not receive treatment; late treatment initiation was not associated with a significant reduction in stay.

IN PRACTICE

“[The study] findings suggest that healthcare professionals should encourage caregivers of children to seek care early in the course of influenza-like illness and also urgently consider oseltamivir treatment for all children and adolescents hospitalized with suspected or confirmed influenza,” the authors wrote.

SOURCE

This study was led by Kacie Rytlewski, MD, of the Department of Pediatrics at the University of Colorado School of Medicine and Children's Hospital Colorado in Aurora, Colorado. It was published online on August 10, 2026, in JAMA Pediatrics.

LIMITATIONS

The study relied on data captured across multiple sites and seasons, which had variations. Influenza testing was performed at clinician discretion, so children with influenza-like symptoms without laboratory confirmation were not included.

DISCLOSURES

This study was funded by the CDC through Emerging Infections Program and Council of State and Territorial Epidemiologists cooperative agreements. Several authors reported receiving grants from the CDC during the conduct of the study and reported receiving grants, fees, or having other ties with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.