Despite national guidelines recommending antiviral treatment for children hospitalized with Flu, a new study published in Clinical Infectious Diseases finds that nearly half of these patients are not receiving the medication.
The research, led by Dr. James Antoon of Monroe Carell Jr. Children’s Hospital at Vanderbilt, raises concerns about adherence to widely accepted medical recommendations and highlights the need for improved influenza testing and treatment protocols.
Antivirals Reduce Flu Severity, Yet Many Children Aren’t Receiving Them
Influenza contributes to up to 10% of all pediatric hospitalizations during the U.S. winter season. Current guidelines from the CDC, Infectious Diseases Society of America (IDSA), and the American Academy of Pediatrics recommend that all hospitalized children with suspected or confirmed it receive antiviral treatment, regardless of symptom duration or vaccination status.
However, the study, which examined 1,213 hospitalized children with lab-confirmed it across seven pediatric medical centers, found that:
- Only half of all hospitalized children received antiviral treatment.
- Among children diagnosed through clinical influenza testing, nearly two-thirds received antivirals.
- 37% of infants under six months old—who are too young to receive a its vaccine—did not receive antiviral treatment.
“Our findings of limited use of antivirals in hospitalized children with influenza illness is concerning,” said Dr. Antoon. “These medications reduce symptom duration and lower the risk of serious complications, such as pneumonia, sinusitis, and ear infections. They may also decrease hospital stays, ICU admissions, and the need for mechanical ventilation.”
Declining Antiviral Use Over Time
The study also aligns with broader national trends, indicating a decline in antiviral prescriptions for hospitalized children.
According to Dr. Natasha Halasa, Craig Weaver Professor of Pediatrics at Monroe Carell, data from two national flu surveillance networks show that:
- From 2017 to 2018, antiviral treatment rates ranged from 70% to 86%.
- By 2023-2024, the rate had dropped to below 60%.
- Among higher-risk children and adolescents seen in outpatient settings, only 30% were prescribed antivirals.
These findings were also reported in the CDC’s Morbidity and Mortality Weekly Report (MMWR) on November 14, 2024.
The Need for Improved Flu Testing and Standardized Treatment Protocols
The researchers emphasize identifying barriers to antiviral use, particularly for high-risk children and infants.
“The low use of influenza antivirals highlights the need for improved clinical testing and treatment adherence,” said Antoon. “Future studies should focus on enhancing its testing, ensuring timely antiviral administration, and standardizing care across healthcare systems.”
As influenza cases rise each winter, experts stress that closing this treatment gap could significantly improve health outcomes for children, reduce hospital stays, and prevent severe flu complications.
Reference: James W Antoon, Justin Z Amarin, Olla Hamdan, Tess Stopczynski, Laura S Stewart, Marian G Michaels, John V Williams, Eileen J Klein, Janet A Englund, Geoffrey A Weinberg, Peter G Szilagyi, Jennifer E Schuster, Rangaraj Selvarangan, Christopher J Harrison, Julie A Boom, Leila C Sahni, Flor M Muñoz, Mary Allen Staat, Elizabeth P Schlaudecker, James D Chappell, Benjamin R Clopper, Heidi L Moline, Angela P Campbell, Andrew J Spieker, Samantha M Olson, Natasha B Halasa. Antiviral Use Among Children Hospitalized With Laboratory-Confirmed Influenza Illness: A Prospective, Multicenter Surveillance Study. Clinical Infectious Diseases, 2024.
