Impact of oseltamivir treatment on the incidence and course of acute otitis media in children with influenza.
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.
Winther
Birgit
B
Department of Otolaryngology, Head and Neck Surgery, University of Virginia, PO Box 800713, Charlottesville, VA 22908-0713, USA. kma@virginia.edu
Block
Stan L
SL
Reisinger
Keith
K
Dutkowski
Regina
R
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*
D000998:Antiviral Agents; D053139:Oseltamivir