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​In 2009, a global influenza pandemic, influenza A (2009 H1N1), severely sickened and killed thousands of people, including many in the United States. Since the onset of the H1N1 pandemic, prompt administration of antiviral drugs has been recommended for all patients with a suspected or confirmed influenza diagnosis severe enough to require hospitalization.

In a December 2013 Pediatrics study, “Neuraminidase Inhibitors for Critically Ill Children with Influenza,” published online Nov. 25, researchers studied data on the outcomes of 784 children in California aged 0 to 17 years who were hospitalized in an intensive care unit (ICU) with laboratory-confirmed influenza from April 2009 to September 2012.

During the H1N1 pandemic, 90 percent of children received treatment with a type of antiviral medication called a neuraminidase inhibitor (NAI), compared to 63 percent of children in the post-pandemic period. Six percent (38 of 653) cases treated with an NAI died, compared to 8 percent (11 of 131) of untreated cases. Further statistical analysis found that NAI treatment significantly reduced the risk of death in the most critically ill cases, including those requiring mechanical ventilation. Cases treated with NAIs within 48 hours of the onset of symptoms were also less likely to die compared to patients who were never treated.

Study authors conclude that better efforts are needed to educate clinicians on the benefits of NAIs in treating critically ill children hospitalized with influenza.

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