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Evidence summaries

Neuraminidase Inhibitors for Preventing and Treating Influenza in Children

Oseltamivir and zanamivir appear to have modest benefit in reducing duration of illness in children with influenza. Level of evidence: "B"

Comment: The quality of evidence is downgraded by imprecise results (few patients for each comparison).

A Cochrane review [Abstract] 1 included 6 studies with a total of 2356 children, of whom 1255 had laboratory-confirmed influenza.

In children with laboratory-confirmed influenza oseltamivir reduced median duration of illness by 36 hours (26%). Zanamivir reduced median duration of illness by 1.3 days (24%). Oseltamivir significantly reduced acute otitis media in children aged one to five years with laboratory-confirmed influenza (risk difference (RD) -0.14, 95% CI -0.24 to -0.04). Prophylaxis with either zanamivir or oseltamivir was associated with an 8% absolute reduction in developing influenza after the introduction of a case into a household (RD -0.08, 95% CI -0.12 to -0.05). The adverse event profile of zanamivir was no worse than placebo but vomiting was more commonly associated with oseltamivir (number needed to harm = 17, 95% CI 10 to 34).

    References

    • Wang K, Shun-Shin M, Gill P et al. Neuraminidase inhibitors for preventing and treating influenza in children (published trials only). Cochrane Database Syst Rev 2012;4():CD002744. [PubMed]

Primary/Secondary Keywords