{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T11:22:12Z","timestamp":1793013732920,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Oseltamivir therapy is recommended for all pediatric inpatients with influenza, particularly those with high-risk conditions, although data regarding its uptake and benefits are limited.<\/jats:p><\/jats:sec>Objective<\/jats:title>To describe temporal patterns and independent patient factors associated with the use of oseltamivir and explore patterns in resource use and patient outcomes among children hospitalized with influenza.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This multicenter retrospective cross-sectional study was conducted at 36 tertiary pediatric hospitals participating in the Pediatric Health Information System in the US. A total of 70\u202f473 children younger than 18 years who were hospitalized with influenza between October 1, 2007, and March 31, 2020, were included.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Hospitalization with a diagnosis of influenza.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was the use of oseltamivir, which was described by influenza season and by hospital. Patient factors associated with oseltamivir use were assessed using multivariable mixed-effects logistic regression models. Secondary outcomes were resource use (including antibiotic medications, chest radiography, supplemental oxygen, positive pressure ventilation, central venous catheter, and intensive care unit [ICU]) and patient outcomes (length of stay, late ICU transfer, 7-day hospital readmission, use of extracorporeal membrane oxygenation, and in-hospital mortality), which were described as percentages per influenza season.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 70\u202f473 children hospitalized with influenza, the median (IQR) age was 3.65 (1.05-8.26) years; 30\u202f750 patients (43.6%) were female, and 39\u202f715 (56.4%) were male. Overall, 16 559 patients (23.5%) were Black, 36 184 (51.3%) were White, 14 133 (20.1%) were of other races (including 694 American Indian or Alaska Native [1.0%], 2216 Asian [3.0%], 372 Native Hawaiian or Pacific Islander [0.5%], and 10 850 other races [15.4%]), and 3597 (5.1%) were of unknown race. A total of 47\u202f071 patients (66.8%) received oseltamivir, increasing from a low of 20.2% in the 2007-2008 influenza season to a high of 77.9% in the 2017-2018 season. Use by hospital ranged from 43.2% to 79.7% over the entire study period and from 56.5% to 90.1% in final influenza season studied (2019-2020). Factors associated with increased oseltamivir use included the presence of a complex chronic condition (odds ratio [OR], 1.42; 95% CI, 1.36-1.47), a history of asthma (OR, 1.31; 95% CI, 1.23-1.38), and early severe illness (OR, 1.19; 95% CI, 1.13-1.25). Children younger than 2 years (OR, 0.81; 95% CI, 0.77-0.85) and children aged 2 to 5 years (OR, 0.83; 95% CI, 0.79-0.88) had lower odds of receiving oseltamivir. From the beginning (2007-2008) to the end (2019-2020) of the study period, the use of antibiotic medications (from 74.4% to 60.1%) and chest radiography (from 59.2% to 51.7%) decreased, whereas the use of oxygen (from 33.6% to 29.3%), positive pressure ventilation (from 10.8% to 7.9%), and central venous catheters (from 2.5% to 1.0%) did not meaningfully change. Patient outcomes, including length of stay (median [IQR], 3 [2-5] days for all seasons), readmissions within 7 days (from 4.0% to 3.4%), use of extracorporeal membrane oxygenation (from 0.5% to 0.5%), and in-hospital mortality (from 1.1% to 0.8%), were stable from the beginning to the end of the study period.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cross-sectional study of children hospitalized with influenza, the use of oseltamivir increased over time, particularly among patients with high-risk conditions, but with wide institutional variation. Patient outcomes remained largely unchanged. Further work is needed to evaluate the impact of oseltamivir therapy in this population.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.33027","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T15:34:27Z","timestamp":1663947267000},"page":"e2233027","source":"Crossref","is-referenced-by-count":16,"title":["Assessment of Temporal Patterns and Patient Factors Associated With Oseltamivir Administration in Children Hospitalized With Influenza, 2007-2020"],"prefix":"10.1001","volume":"5","author":[{"given":"Patrick S.","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section of Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schnadower","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriram","family":"Ramgopal","sequence":"additional","affiliation":[{"name":"Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Division of Emergency Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"},{"name":"Division of Hospital Medicine, Cincinnati Children\u2019s Hospital Medicine Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paria M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"issue":"1","key":"zoi220938r1","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/irv.2018.12.issue-1","article-title":"Annual estimates of the burden of seasonal influenza in the United States: a tool for strengthening influenza surveillance and preparedness.","volume":"12","author":"Rolfes","year":"2018","journal-title":"Influenza Other Respir Viruses"},{"issue":"4","key":"zoi220938r2","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1542\/peds.2007-0164","article-title":"Prevention of influenza: recommendations for influenza immunization of children, 2006-2007.","volume":"119","author":"American Academy of Pediatrics Committee on Infectious Diseases","year":"2007","journal-title":"Pediatrics"},{"issue":"4","key":"zoi220938r4","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1542\/peds.2010-2216","article-title":"Policy statement\u2013recommendations for prevention and control of influenza in children, 2010-2011.","volume":"126","author":"Committee on Infectious Diseases","year":"2010","journal-title":"Pediatrics"},{"issue":"8","key":"zoi220938r5","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1086\/598513","article-title":"Seasonal influenza in adults and children\u2014diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America.","volume":"48","author":"Harper","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"4","key":"zoi220938r6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-2367","article-title":"Recommendations for prevention and control of influenza in children, 2018-2019.","volume":"142","author":"Committee on Infectious Diseases","year":"2018","journal-title":"Pediatrics"},{"issue":"6","key":"zoi220938r7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciy866","article-title":"Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza.","volume":"68","author":"Uyeki","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"3","key":"zoi220938r8","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1001\/jamapediatrics.2016.3484","article-title":"Limited and variable use of antivirals for children hospitalized with influenza.","volume":"171","author":"Stockmann","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"3","key":"zoi220938r9","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1093\/cid\/ciw745","article-title":"Increased antiviral treatment among hospitalized children and adults with laboratory-confirmed influenza, 2010-2015.","volume":"64","author":"Appiah","year":"2017","journal-title":"Clin Infect Dis"},{"key":"zoi220938r10","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1186\/1471-2334-11-313","article-title":"Pandemic A\/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey.","volume":"11","author":"Blumental","year":"2011","journal-title":"BMC Infect Dis"},{"issue":"3","key":"zoi220938r11","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1542\/hpeds.2015-0126","article-title":"Rising oseltamivir use among hospitalized children in a postpandemic era.","volume":"6","author":"Williams","year":"2016","journal-title":"Hosp Pediatr"},{"issue":"6","key":"zoi220938r12","doi-asserted-by":"publisher","first-page":"949","DOI":"10.3201\/eid2206.151037","article-title":"Debate regarding oseltamivir use for seasonal and pandemic influenza.","volume":"22","author":"Hurt","year":"2016","journal-title":"Emerg Infect Dis"},{"issue":"10","key":"zoi220938r15","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.3201\/eid1210.051525","article-title":"ICD-9 codes for identifying influenza hospitalizations in children.","volume":"12","author":"Keren","year":"2006","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"zoi220938r16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1093\/jpids\/pis052","article-title":"Use of administrative data for the identification of laboratory-confirmed influenza infection: the validity of influenza-specific ICD-9 codes.","volume":"2","author":"Feemster","year":"2013","journal-title":"J Pediatric Infect Dis Soc"},{"key":"zoi220938r17","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/1471-2431-14-199","article-title":"Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.","volume":"14","author":"Feudtner","year":"2014","journal-title":"BMC Pediatr"},{"issue":"11","key":"zoi220938r18","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1001\/jama.292.11.1333","article-title":"Influenza-associated hospitalizations in the United States.","volume":"292","author":"Thompson","year":"2004","journal-title":"JAMA"},{"issue":"4","key":"zoi220938r19","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-049672","article-title":"Antiviral use in Canadian children hospitalized for influenza.","volume":"148","author":"Mehta","year":"2021","journal-title":"Pediatrics"},{"issue":"4","key":"zoi220938r20","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1093\/aje\/kwv068","article-title":"Age and sex differences in rates of influenza-associated hospitalizations in Hong Kong.","volume":"182","author":"Wang","year":"2015","journal-title":"Am J Epidemiol"},{"issue":"6","key":"zoi220938r21","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1542\/peds.2010-1275","article-title":"Variability in antibiotic use at children\u2019s hospitals.","volume":"126","author":"Gerber","year":"2010","journal-title":"Pediatrics"},{"issue":"5","key":"zoi220938r22","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1017\/ice.2019.373","article-title":"Considerable variability in antibiotic use among US children\u2019s hospitals in 2017-2018.","volume":"41","author":"Griffith","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3","key":"zoi220938r23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2816","article-title":"Trends in chest radiographs for pneumonia in emergency departments.","volume":"145","author":"Geanacopoulos","year":"2020","journal-title":"Pediatrics"},{"issue":"9","key":"zoi220938r24","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1097\/PCC.0000000000000843","article-title":"Global trends in extracorporeal membranous oxygenation use and survival of patients with influenza-associated illness.","volume":"17","author":"de St Maurice","year":"2016","journal-title":"Pediatr Crit Care Med"},{"key":"zoi220938r25","doi-asserted-by":"publisher","first-page":"g2545","DOI":"10.1136\/bmj.g2545","article-title":"Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments.","volume":"348","author":"Jefferson","year":"2014","journal-title":"BMJ"},{"key":"zoi220938r26","doi-asserted-by":"publisher","first-page":"j2841","DOI":"10.1136\/bmj.j2841","article-title":"WHO downgrades oseltamivir on drugs list after reviewing evidence.","volume":"357","author":"Kmietowicz","year":"2017","journal-title":"BMJ"},{"issue":"1","key":"zoi220938r27","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.healthpol.2013.08.002","article-title":"A systematic review of medical practice variation in OECD countries.","volume":"114","author":"Corallo","year":"2014","journal-title":"Health Policy"},{"issue":"7","key":"zoi220938r28","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1111\/jpc.13212","article-title":"Variation in paediatric clinical practice: a review of care in inpatient, outpatient and emergency department settings.","volume":"52","author":"Hiscock","year":"2016","journal-title":"J Paediatr Child Health"},{"issue":"7","key":"zoi220938r29","doi-asserted-by":"publisher","first-page":"512","DOI":"10.7326\/0003-4819-156-7-201204030-00411","article-title":"Antivirals for treatment of influenza: a systematic review and meta-analysis of observational studies.","volume":"156","author":"Hsu","year":"2012","journal-title":"Ann Intern Med"},{"issue":"10","key":"zoi220938r30","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1093\/cid\/cix1040","article-title":"Efficacy and safety of oseltamivir in children: systematic review and individual patient data meta-analysis of randomized controlled trials.","volume":"66","author":"Malosh","year":"2018","journal-title":"Clin Infect Dis"},{"issue":"11","key":"zoi220938r31","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1097\/INF.0b013e318232ede9","article-title":"Oseltamivir shortens hospital stays of critically ill children hospitalized with seasonal influenza: a retrospective cohort study.","volume":"30","author":"Coffin","year":"2011","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"zoi220938r32","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-050417","article-title":"Influenza antiviral treatment and length of stay.","volume":"148","author":"Campbell","year":"2021","journal-title":"Pediatrics"},{"issue":"6","key":"zoi220938r33","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1542\/hpeds.2014-0045","article-title":"Hospital readmissions among children with H1N1 influenza infection.","volume":"4","author":"Brogan","year":"2014","journal-title":"Hosp Pediatr"},{"issue":"6","key":"zoi220938r34","doi-asserted-by":"publisher","first-page":"e1539","DOI":"10.1542\/peds.2013-2149","article-title":"Neuraminidase inhibitors for critically ill children with influenza.","volume":"132","author":"Louie","year":"2013","journal-title":"Pediatrics"},{"issue":"7","key":"zoi220938r35","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1197\/j.aem.2007.03.1357","article-title":"Lack of agreement in pediatric emergency department discharge diagnoses from clinical and administrative data sources.","volume":"14","author":"Gorelick","year":"2007","journal-title":"Acad Emerg Med"},{"key":"zoi220938r36","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/1472-6963-14-70","article-title":"Coding of obesity in administrative hospital discharge abstract data: accuracy and impact for future research studies.","volume":"14","author":"Martin","year":"2014","journal-title":"BMC Health Serv Res"},{"issue":"9","key":"zoi220938r37","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1016\/j.ajem.2018.12.015","article-title":"Characterizing pediatric high frequency users of California emergency departments.","volume":"37","author":"Supat","year":"2019","journal-title":"Am J Emerg Med"},{"key":"zoi220938r3","unstructured":"American Academy of Pediatrics. Red Book Online. American Academy of Pediatrics. September 20, 2021. Accessed August 18, 2022. https:\/\/publications.aap.org\/redbook\/resources\/15504"},{"key":"zoi220938r13","unstructured":"Children\u2019s Hospital Association. Leverage clinical and resource utilization data. Children\u2019s Hospital Association. Updated October 19, 2020. Accessed November 29, 2021. https:\/\/www.childrenshospitals.org\/content\/analytics\/product-program\/pediatric-health-information-system"},{"key":"zoi220938r14","unstructured":"Fingar? KR, Liang? L, Stocks? C. Statistical brief #253: inpatient hospital stays and emergency department visits involving influenza, 2006-2016. In: Health Care Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality; October 2019. Accessed December 1, 2021. https:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb253-Influenza-Hospitalizations-ED-Visits-2006-2016.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2796646\/walsh_2022_oi_220938_1663342849.46975.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T15:34:35Z","timestamp":1663947275000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2796646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.33027","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,23]]}}}