title: Rising Oseltamivir Use Among Hospitalized Children in a Postpandemic Era.
abstract: BACKGROUND
  Oseltamivir prescribing among pediatric inpatients with influenza varied from 2% to 48% prior to the 2009 H1N1 pandemic. After the pandemic, prescribing guidelines were expanded, and studies reported benefits for hospitalized children. Post-pandemic prescribing practices among children are unclear.
  
  
  OBJECTIVE
  To report the rate of oseltamivir use and to identify factors associated with its use among inpatients with confirmed influenza infection from 2010 to 2014 at a tertiary children's hospital.
  
  
  METHODS
  We conducted a retrospective cohort study of inpatients with polymerase chain reaction-confirmed influenza from December 2010 to April 2014 at Children's Hospital Colorado. The primary outcome was oseltamivir use. Variables regarding demographics, underlying medical conditions, diagnoses, and hospital course were also explored. Univariate and multivariate logistic regression analyses were performed.
  
  
  RESULTS
  Among 395 inpatients with influenza, 323 (82%) received oseltamivir. In univariate analyses, oseltamivir use was associated with admission within 48 hours of symptom onset (89% vs 77%), ICU admission (88% vs 79%), longer length of stay (90% for >6 days vs 77% for ≤2 days), and influenza A H1N1 infection (P < .05 for all). In multivariate logistic regression analysis, longer length of stay, illness during the 2013-2014 season, and admission within 48 hours of symptom onset were associated with higher odds of oseltamivir use.
  
  
  CONCLUSIONS
  Oseltamivir use for children with influenza in the postpandemic era is increasing at our institution, aligning with official recommendations and reported benefits. We report highest use for patients in the 2013-2014 season, those who present early in their illness, and those requiring a prolonged hospital stay.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; and.
authors.forename: Joshua T B
authors.initials: JT
authors.lastname: Williams
authors.affiliation: Department of Pediatrics (Hospital Medicine and.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Cunningham
authors.affiliation: Department of Pediatrics (Hospital Medicine and.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Wilson
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; and Department of Pediatrics (Hospital Medicine and Infectious Diseases), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado suchitra.rao@childrenscolorado.org.
authors.forename: Suchitra
authors.initials: S
authors.lastname: Rao
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D004363:Drug Utilization / Q000706:statistics & numerical data; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy*; D053139:Oseltamivir / Q000627:therapeutic use*; D058873:Pandemics; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir