Introduction

In a concerning trend highlighted by recent data, the use of antiviral medications among hospitalized pediatric patients with influenza has plummeted to alarming levels—between 52% and 59%—since the onset of the COVID-19 pandemic. This decline has raised warnings from health experts who stress the significance of timely antiviral treatment in preventing severe complications associated with the flu.

Historical Context

Historically, antiviral treatment has been more commonly administered to children with underlying health conditions, as well as those under six months of age. Shockingly, children without any underlying medical issues are now less likely to receive these critical antiviral medications compared to their peers with multiple health challenges.

Hospitalization Statistics

Every year in the United States, tens of thousands of children and adolescents are hospitalized due to influenza, a fact emphasized in the latest Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC). Vaccinations and antiviral treatments play crucial roles in mitigating the risk of influenza complications, yet recent trends reveal a troubling pattern of underutilization among vulnerable pediatric patients.

Current Treatment Rates

The data reveals that the percentage of hospitalized patients under 18 years old receiving antiviral treatments dropped significantly from previous years. Specifically, in the 2019-2020 influenza season, 70% of pediatric patients in the New Vaccine Surveillance Network (NVSN) were treated, and 86% in the Influenza Hospitalization Surveillance Network (FluSurv-NET). Fast forward to the current 2023-2024 season, and those numbers have sunk to between 52% and 59%.

Outpatient Treatment Challenges

Further complications have arisen in the outpatient setting, where only 31% of children recommended for antiviral treatment actually received it. Alarmingly, only 52% of hospitalized children in the NVSN and 59% in FluSurv-NET were treated, displaying a concerning gap in care. Young infants, particularly those under six months, exhibited the highest treatment rates (68% in NVSN and 73% in FluSurv-NET), while older children, particularly those aged 2-4 years, had the lowest rates of antiviral prescription.

Dominant Antiviral Treatment

The predominant antiviral treatment administered was oseltamivir (99% of cases), yet this has not been without controversy. Concerns regarding the potential neuropsychiatric side effects of oseltamivir have been raised, sparking discussions among healthcare providers about the balance of risks and benefits when treating pediatric influenza patients.

Healthcare Provider Insights

At the 2024 National Association of Pediatric Nurse Practitioners National Conference, pediatric nurse practitioner Ashley Gyura emphasized the need for continued research into the neuropsychiatric implications of oseltamivir, noting that serious events can occur in children, regardless of antiviral use. This insight could prove vital as practitioners strive to navigate treatment protocols for pediatric patients amid heightened scrutiny and awareness of prescription medications' side effects.

Need for Action

The MMWR underscores the increasing necessity of antiviral treatment correlating with the number of underlying conditions. In outpatient settings, the percentage of children treated rises dramatically from 28% among those with no conditions to 57% among those with three or more. Similar trends were observed in hospitalized patients across both surveillance networks, indicating an urgent appeal for more consistent antiviral prescribing practices.

Conclusion

Experts urge healthcare providers to act promptly in administering antiviral treatments to children and adolescents exhibiting symptoms of influenza, especially those at greater risk for severe outcomes. As flu season intensifies, we encourage all parents and guardians to stay informed about the symptoms of influenza and the importance of prompt medical treatment to safeguard the health of their children.