{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:49:05Z","timestamp":1786963745870,"version":"build-2736575974"},"reference-count":25,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["National School for Primary Care Research (SPCR) p"],"award-info":[{"award-number":["National School for Primary Care Research (SPCR) p"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,5,22]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Influenza and influenza-like illness (ILI) place considerable burden on healthcare systems, especially during influenza epidemics and pandemics. During the 2009\/10 H1N1 influenza pandemic, UK national guidelines recommended antiviral medications for patients presenting within 72\u2005h of ILI onset. However, it is not clear whether antiviral treatment was associated with reductions in influenza-related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our study population consisted of a retrospective cohort of children aged \u226417\u2005years who presented with influenza\/ILI at UK primary care practices contributing to the Clinical Practice Research Datalink during the 2009\/10 pandemic. We used doubly robust inverse-probability weighted propensity scores and physician prior prescribing instrumental variable methods to estimate the causal effect of oseltamivir prescribing on influenza-related complications. Secondary outcomes were complications requiring intervention, pneumonia, pneumonia or hospitalisation, influenza-related hospitalisation and all-cause hospitalisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 16\u200a162 children, of whom 4028 (24.9%) were prescribed oseltamivir, and 753 (4.7%) had recorded complications. Under propensity score analyses oseltamivir prescriptions were associated with reduced influenza-related complications (risk difference (RD) \u22120.015, 95% CI \u22120.022\u2013\u22120.008), complications requiring further intervention, pneumonia, pneumonia or hospitalisation and influenza-related hospitalisation, but not all-cause hospitalisation. Adjusted instrumental variable analyses estimated reduced influenza-related complications (RD \u22120.032, 95% CI \u22120.051\u2013\u22120.013), pneumonia or hospitalisation, all-cause and influenza-related hospitalisations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on causal inference analyses of observational data, oseltamivir treatment in children with influenza\/ILI was associated with a small but statistically significant reduction in influenza-related complications during an influenza pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.02246-2019","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T19:02:00Z","timestamp":1591902120000},"page":"1902246","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Oseltamivir and influenza-related complications in children: a retrospective cohort in primary care"],"prefix":"10.1183","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4033-0915","authenticated-orcid":false,"given":"Joseph Jonathan","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Bankhead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Perera Salazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis A.","family":"Kousoulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Butler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"2024102101445973000_56.5.1902246.1","unstructured":"Hine D . The 2009 Influenza Pandemic: An Independent Review of the UK Response to the 2009 Influenza Pandemic. 2010. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/61252\/the2009influenzapandemic-review.pdf"},{"key":"2024102101445973000_56.5.1902246.2","doi-asserted-by":"publisher","DOI":"10.3310\/hta20220"},{"key":"2024102101445973000_56.5.1902246.3","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008965.pub4"},{"key":"2024102101445973000_56.5.1902246.4","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810002657"},{"key":"2024102101445973000_56.5.1902246.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.135210"},{"key":"2024102101445973000_56.5.1902246.6","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1017\/S0950268818000353","article-title":"Risk factors for influenza-related complications in children during the 2009\/10 pandemic: a UK primary care cohort study using linked routinely collected data","volume":"146","author":"Lee","year":"2018","journal-title":"Epidemiol Infect"},{"key":"2024102101445973000_56.5.1902246.7","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"2024102101445973000_56.5.1902246.8","unstructured":"National Institute for Health and Care Excellence (NICE) . Influenza \u2013 Seasonal. Date last accessed: November 6, 2015. Date last updated: April 2019. http:\/\/cks.nice.org.uk\/influenza-seasonal"},{"key":"2024102101445973000_56.5.1902246.9","unstructured":"McLean E , Pebody R . Epidemiological Report of Pandemic (H1N1) 2009 in the UK. Health Protection Agency 2010. www.hpa.org.uk\/Publications\/InfectiousDiseases\/Influenza\/1010EpidemiologicalreportofpandemicH1N12009inUK\/"},{"key":"2024102101445973000_56.5.1902246.10","doi-asserted-by":"publisher","DOI":"10.1007\/s100960000376"},{"key":"2024102101445973000_56.5.1902246.11","unstructured":"Department for Communities and Local Government . 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