Title: Is there benefit to early oseltamivir in otherwise healthy pediatric patients with influenza? (Submitted by Sam Cordiero, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p> The answer appears to be ... it depends.</p> <p> <em>Early Oseltamivir Treatment in Influenza in Children1-3 Years of Age: A Randomized Controlled Trial</em></p> <p> A study in 2010 out of Finland by Heinonen, et al showed that if given<strong> in the first 12 hours </strong>of symptom onset to otherwise healthy pediatric patients between the age of 1-3 years:</p> <p> - decrease incidence of acute otitis media by 85%</p> <p> - no difference if given within 24 hours</p> <p> Among children with <strong>influenza A</strong>, oseltamivir started <strong>within 24 hours</strong> of symptom onset</p> <p> - shortened medium time to resolution of illness by 3.5 days (3.0 versus 6.5) in all children</p> <p> - shortened median time to resolution of illness by 4.0 days in UNvaccinated children</p> <p> - Reduced parental work absenteeism by 3 days</p> <p> * no differences were seen in children with influenza B *</p> <p> Limitations***</p> <p> - Single Center study in Finland</p> <p> - The authors received support from the drug manufacturer</p> <p> - The sample size of children with confirmed influenza cases with small (influenza A: 79, influenza B: 19)</p> <p> Takeaway:</p> <p> If you have a patient between the age of 1-3 years with very early symptoms concerning for flu, a positive rapid influenza A test<u><em> could </em></u>allow you to cut her symptoms by 3 days, prevent complications, and allow parents to go back to work sooner.</p> <div style="left: -1000px; top: 180.59px; width: 1px; height: 1px; overflow: hidden; position: absolute;"> </div>
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<fieldset><legend>References</legend>
<p> Heinonen S, Silvennoinen H, Lehtinen et al. Early oseltamivir treatment of influenza in children 1-3 years of age: A randomized controlled trial. Clin Infect Dis. 2010;51(8):87-94.</p> </fieldset>