Oseltamivir Linked to Lower ICU Risk in Children

A retrospective cohort study published in JAMA Pediatrics found that oseltamivir treatment was associated with a lower risk of intensive care unit (ICU) admission and shorter hospital stays among children hospitalized with laboratory-confirmed influenza. The study analyzed population-based surveillance data from 13 US states across 8 influenza seasons.

Investigators used Influenza Hospitalization Surveillance Network (FluSurv-NET) data from the 2014-2015 through 2022-2023 seasons, excluding 2020-2021. Participants were younger than 18 years and had a documented respiratory symptom onset date. Oseltamivir receipt was modeled as a time-dependent exposure. The primary outcome was time from symptom onset to ICU admission; the secondary outcome was hospital length of stay (LOS).

After exclusions, the ICU analysis included 6044 cases, of which 4240 (70.2%) received oseltamivir. The LOS analysis included 7103 cases, of which 5746 (80.9%) received treatment. Compared with no treatment, oseltamivir was linked to fewer ICU admissions and shorter hospital stays.

Estimated LOS was 3.33 days among treated patients and 3.72 days among untreated patients, corresponding to a 9.4-hour reduction. Early treatment was associated with shorter LOS, while late treatment was not significantly associated with that outcome. Both early and late treatment were associated with lower ICU admission hazards compared with no treatment.

The investigators noted that the retrospective, observational design precluded adjustment for all potential confounders. Other limitations included possible oseltamivir exposure misclassification, clinician-directed influenza testing, and surveillance coverage representing approximately 9% of the US population. The authors concluded that the findings support national recommendations for oseltamivir treatment in children hospitalized with influenza.

Source: Rytlewski K, Dunn A, O’Halloran A, et al. Effectiveness of oseltamivir in hospitalized children with laboratory-confirmed influenza, 2014-2023. JAMA Pediatr. Published online August 10, 2026. doi:10.1001/jamapediatrics.2026.3376