Antoon JW, Hall M, Feinstein JA, Kyler KE, Shah SS. Guideline Concordant Antiviral Treatment in Children at High-risk for Influenza Complications. Clin Infect Dis. 2022 Jul 22:ciac606
Background: National guidelines recommend antiviral treatment for children with influenza at high-risk for complications regardless of symptom duration. Little is known about concordance of clinical practice with this recommendation.
Methods: We performed a cross-sectional study of outpatient children (1-18 years) at high-risk for complications who were diagnosed with influenza during the 2016-2019 influenza seasons using the MarketScan Medicaid database. High-risk status was determined using an existing definition including age, co-morbidities, and residence in a long-term care facility. The primary outcome was influenza antiviral dispensing within 2 days of influenza diagnosis. We determined patient and provider level factors associated with guideline concordant treatment using multivariable logistic regression.
Results: Of the 274,213 children with influenza at high-risk for influenza complications, 11,4863 (58.1%) received antiviral treatment. Antiviral treatment was associated with the presence of asthma (adjusted odds ratio 1.13, 95% CI 1.11, 1.16), immunosuppression (aOR 1.10, 95% CI 1.05, 1.16), complex chronic conditions (aOR 1.04, 95% CI 1.01,1.07) and index encounter in the urgent care setting (aOR 1.3, 95% CI 1.26, 1.34). Factors associated with decreased odds of antiviral treatment include age 2-5 years compared to 6-17 years (aOR 0.95, 95% CI 0.93, 0.97), residing in a chronic care facility (aOR 0.61, 95% CI 0.46, 0.81), and index encounter in an emergency department (aOR 0.66, 95% CI 0.63, 71).
Conclusions: Among children with influenza at high-risk for complications, 42% did not receive guideline concordant antiviral treatment. Further study is needed to elucidate barriers to appropriate use of antivirals in this vulnerable population.
Methods: We performed a cross-sectional study of outpatient children (1-18 years) at high-risk for complications who were diagnosed with influenza during the 2016-2019 influenza seasons using the MarketScan Medicaid database. High-risk status was determined using an existing definition including age, co-morbidities, and residence in a long-term care facility. The primary outcome was influenza antiviral dispensing within 2 days of influenza diagnosis. We determined patient and provider level factors associated with guideline concordant treatment using multivariable logistic regression.
Results: Of the 274,213 children with influenza at high-risk for influenza complications, 11,4863 (58.1%) received antiviral treatment. Antiviral treatment was associated with the presence of asthma (adjusted odds ratio 1.13, 95% CI 1.11, 1.16), immunosuppression (aOR 1.10, 95% CI 1.05, 1.16), complex chronic conditions (aOR 1.04, 95% CI 1.01,1.07) and index encounter in the urgent care setting (aOR 1.3, 95% CI 1.26, 1.34). Factors associated with decreased odds of antiviral treatment include age 2-5 years compared to 6-17 years (aOR 0.95, 95% CI 0.93, 0.97), residing in a chronic care facility (aOR 0.61, 95% CI 0.46, 0.81), and index encounter in an emergency department (aOR 0.66, 95% CI 0.63, 71).
Conclusions: Among children with influenza at high-risk for complications, 42% did not receive guideline concordant antiviral treatment. Further study is needed to elucidate barriers to appropriate use of antivirals in this vulnerable population.
See Also:
Latest articles in those days:
- Epidemiological characteristics of human infections with avian influenza A(H5N6) virus, China and Laos: A multiple case descriptive analysis, February 2014-June 2023 5 hours ago
- Interim Estimates of 2023-2024 Seasonal Influenza Vaccine Effectiveness Among Adults in Korea 15 hours ago
- Abundant Intra-Subtype Reassortment Revealed in H13N8 Influenza Viruses 2 days ago
- Locations and structures of influenza A virus packaging-associated signals and other functional elements via an in silico pipeline for predicting constrained features in RNA viruses 2 days ago
- Molecular Characterization of Non-H5 and Non-H7 Avian Influenza Viruses from Non-Mallard Migratory Waterbirds of the North American Flyways, 2006~2011 2 days ago
[Go Top] [Close Window]