New US study finds early oseltamivir reduces ICU admissions and hospital stays in children with flu

A comprehensive US analysis reveals that prompt administration of oseltamivir to children hospitalised with influenza significantly lowers ICU admissions and shortens hospital stays, reinforcing early treatment guidelines amid ongoing concerns about severe flu outcomes.

A large US analysis has found that children hospitalised with laboratory-confirmed influenza who received oseltamivir were less likely to need intensive care and tended to leave hospital sooner than those who did not receive the antiviral, according to a study published in JAMA Pediatrics. The research drew on FluSurv-NET, a CDC-supported surveillance system covering 13 states, and examined more than 7,000 paediatric flu admissions recorded over eight seasons from 2014 through 2023. In one of the largest real-world assessments of its kind, the drug was linked to a 31% lower risk of ICU admission.

The findings strengthen a body of evidence suggesting that prompt antiviral treatment can improve outcomes for children with serious influenza. A separate study in JAMA Network Open looked at 55,799 hospitalised children and found that giving oseltamivir on hospital day 0 or 1 was tied to shorter stays and lower odds of late ICU transfer, readmission within 7 days and the combined outcome of death or ECMO use. The CDC has also highlighted earlier work involving 608 hospitalised children, which similarly found that early antiviral treatment, particularly with oseltamivir, was associated with shorter hospital stays.

Researchers say the latest analysis is notable because it took symptom timing and treatment timing into account, two factors that can skew observational studies. That matters because children who get treatment quickly may differ from those who do not in age, underlying illness, severity or access to care. Even so, the study cannot prove causation, only an association. Still, the message aligns with current guidance: children hospitalised with suspected or confirmed flu should be considered for antiviral treatment as soon as possible, even if more than 48 hours have passed since symptoms began.