antivirals for influenza
Multicenter, cross-sectional study of 3378 children diagnosed with influenza (clinical or lab testing). 2514 of the children were considered higher-risk of severe influenza infection (<5 years old, chronic medical conditions, or immunocompromised). About 30% were classified as higher risk because of an underlying medical condition and the remaining 70% due to age <5 years old.
Higher risk patients were less likely to be prescribed antiviral therapy after being diagnosed with influenza in the late pandemic group (15.6%) as compared with prepandemic (32.2%). For both groups, patients who presented to the ED within the first 48 hours of symptoms were more likely to receive an antiviral prescription. Physicians commonly cited rare side effects including vomiting (6%) and neuropsychiatric effects (studies have demonstrated are related to the illness, rather than treatment) as reasons for not recommending antivirals. Study limitations include different age inclusion criteria, variations in severity of influenza by year, uncertainty regarding prescriptions actually being filled, and no assessment of differences in morbidity or mortality between the groups.
Bottom Line: Fewer high-risk patients are being sent home from the ED with prescriptions for antivirals after being diagnosed with influenza since the COVID pandemic. However, it is unclear whether there is a clinical significance (difference in morbidity/mortality). While it is an interesting trend, it is hard to argue that more physicians should be prescribing antivirals based solely on this article.
Higher risk patients were less likely to be prescribed antiviral therapy after being diagnosed with influenza in the late pandemic group (15.6%) as compared with prepandemic (32.2%). For both groups, patients who presented to the ED within the first 48 hours of symptoms were more likely to receive an antiviral prescription. Physicians commonly cited rare side effects including vomiting (6%) and neuropsychiatric effects (studies have demonstrated are related to the illness, rather than treatment) as reasons for not recommending antivirals. Study limitations include different age inclusion criteria, variations in severity of influenza by year, uncertainty regarding prescriptions actually being filled, and no assessment of differences in morbidity or mortality between the groups.
Bottom Line: Fewer high-risk patients are being sent home from the ED with prescriptions for antivirals after being diagnosed with influenza since the COVID pandemic. However, it is unclear whether there is a clinical significance (difference in morbidity/mortality). While it is an interesting trend, it is hard to argue that more physicians should be prescribing antivirals based solely on this article.
