Influenza Treatment in Children and Adolescents Under 18 Years
Influenza in pediatric patients under 18 years requires age-specific antiviral management. Clinical goals and treatment choices differ across infant, child, and adolescent age groups.
Patient population: Pediatric patients from birth through 17 years presenting with influenza. This includes premature infants, term infants, young children, and adolescents — each age group informed by specific clinical considerations when selecting therapy.
Treatment Approach
The recommended strategy involves early initiation of antiviral therapy from the neuraminidase inhibitor class. Agent selection and route of administration are guided by the child's age. Multiple options exist — the full protocol details which apply at each stage of pediatric development.
✓ Goal: Reduce duration of fever and influenza symptoms
References
DOI: 10.1093/cid/ciy866
- Oseltamivir (tablets or oral suspension formulation) may be administered to all pediatric age groups with influenza, including premature infants.
- Duration of therapy for ambulatory children with uncomplicated influenza is 5 days.
- Zanamivir (inhalation) is FDA-approved for treatment of uncomplicated influenza in children aged ≥7 years.
- Dosing and duration of uncomplicated influenza is the same for all pediatric age groups (2 inhalations twice daily for 5 days).
- Peramivir is the only FDA-approved IV antiviral drug and is approved for early treatment of uncomplicated influenza in outpatients aged ≥2 years.
- Systematic reviews and meta-analyses of RCTs indicate that early initiation (within 2 days of illness onset) of antiviral treatment can reduce the duration of fever and symptoms, especially in nonasthmatic children; decrease the risk of otitis media in children; and reduce the risk of lower respiratory tract complications requiring antibiotics and of hospitalization in adults.
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