Pandemic Impacts Children’s Antiviral Prescribing for Influenza

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* Decline in Antiviral Prescriptions: Antiviral prescriptions for children at risk of severe influenza in emergency departments (EDs) decreased significantly – from 32.2% in 2016-2020 to 15.6% in 2021-2023.
* Study Details: this was a multicenter, cross-sectional study spanning 7 influenza seasons. It analyzed data from 2,514 children identified as high-risk out of 3,378 influenza-positive children presenting to 7 US pediatric academic hospitals within the CDC’s New Vaccine Surveillance Network.
* High-Risk Criteria: Children were considered high-risk based on criteria from the American Academy of Pediatrics (AAP), Infectious Diseases Society of America (IDSA), and CDC – including being under 5 years old or having underlying medical conditions (respiratory, cardiovascular, renal, hepatic, hematologic diseases, metabolic or neurologic disorders, or immunosuppression).
* Unchanged Guidelines: Treatment guidelines for influenza remained consistent throughout the study period.
* possible reasons for Decline: the study suggests clinicians may have prioritized confirming a diagnosis (differentiating influenza from COVID-19) over starting timely antiviral treatment. Other factors include delayed test results, perceptions of antiviral effectiveness, and misunderstandings of guidelines.
* Key Finding: There is a widening gap between clinical guidelines and actual practice regarding antiviral treatment for vulnerable pediatric patients.
* Study Authors: Tess Stopczynski, MD, department of Biostatistics, vanderbilt University Medical Center, Nashville, TN and colleagues.