title: Impact of oseltamivir treatment on the incidence and course of acute otitis media in children with influenza.
abstract: OBJECTIVE
  Acute otitis media (AOM) is the most common complication of pediatric influenza, and imposes a substantial health care burden. We examined the influence of oseltamivir treatment on the incidence and course of AOM in children with influenza.
  
  
  METHODS
  In the original study, 695 children 1-12 years who presented within 48h of the onset of influenza-like symptoms were randomized to oseltamivir (2mg/kg) or placebo given twice daily for 5 days. AOM was assessed at enrollment and days 3, 6 (+/-1), 10 (+/-2) and 28 (+/-7). AOM was clinically diagnosed by the participating primary care provider, supported by tympanometry when possible. We performed a retrospective analysis of those participants with laboratory-confirmed influenza (LCI). Assessments included the incidence and clinical course of new AOM cases.
  
  
  RESULTS
  In all, 452 children had LCI; 217 received oseltamivir and 235 placebo. AOM was diagnosed on or after study day 3 at a significantly lower frequency in the oseltamivir versus placebo group (12.4% versus 21.7%; relative risk [RR]: 0.57 [95% CI: 0.37, 0.88], respectively). Treatment effects were greatest for children 1-2 years (RR=0.42 [95% CI: 0.20, 0.89]) and 3-5 years (RR=0.45 [95% CI: 0.19, 1.04]), in whom the incidence of AOM was highest.
  
  
  CONCLUSIONS
  Oseltamivir treatment significantly reduces the emergence of new AOM infections in children with LCI; effects are most pronounced in those <5 years.
  
  
  BACKGROUND
  WV15758.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Virginia, PO Box 800713, Charlottesville, VA 22908-0713, USA. kma@virginia.edu
authors.forename: Birgit
authors.initials: B
authors.lastname: Winther
authors.forename: Stan L
authors.initials: SL
authors.lastname: Block
authors.forename: Keith
authors.initials: K
authors.lastname: Reisinger
authors.forename: Regina
authors.initials: R
authors.lastname: Dutkowski
mesh_terms: D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use*; D010033:Otitis Media / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir