** Recommendations for Childhood Influenza
1.Based on the accumulated experience of oseltamivir in children, relative cost, and ease of use, oseltamivir is the antiviral drug of choice for children with influenza A and B.
2.Based on preliminary pharmacokinetic data and limited safety data, both term and preterm neonates can be treated with oseltamivir** influenza (when the benefits may outweigh the potential risks); If antiviral** is required in lactating patients, oral oseltamivir is recommended.
3.Clinicians should promptly identify children with suspected influenza and work with parents to initiate antiviral** in a timely manner to reduce morbidity and mortality. Antiviral** is most effective in children within 48 hours of symptom onset. If necessary, antiviral therapy should also be considered 48 hours after symptom onset**;
4.The initiation of antivirals** should be based on both influenza-like symptoms and the current epidemic characteristics of influenza. A positive flu test is not required to activate antiviral**.
Influenza prevention recommendations for children
1.Oseltamivir is the antiviral chemoprophylaxis of choice for patients with influenza A and B;
2.Drug prophylaxis is most effective when initiated within 48 hours of exposure to an influenza patient;
3.Drug prophylaxis is recommended in the following situations following known or suspected influenza exposure, including:
a.Children who are at high risk of complications from influenza and have not been vaccinated against influenza this quarter;
b.Children who are at high risk of complications from influenza and have been vaccinated against influenza for less than 2 weeks;
c.Children who are at high risk of complications from influenza and who have been vaccinated against influenza but are immunosuppressed;
d.Children at high risk of influenza complications when the CDC suggests that the community-circulating strain of the influenza virus does not match the seasonal influenza vaccine strain;
e.Family members and close contacts of children at high risk of influenza complications, including healthcare workers, when the CDC suggests that a community-endemic strain of influenza virus does not match a seasonal influenza vaccine strain;
f.Unvaccinated family members and close contacts whose children are: unvaccinated against influenza and at high risk of complications from influenza; 24 months old, not vaccinated against influenza;
g.Family members or close contacts who are at high risk of complications from influenza;
h.Unvaccinated staff and children in closed institutional settings, when there are children at high risk of complications from influenza.
Global surveillance of influenza drug resistance:
1.Viral detection rates with reduced sensitivity to neuraminidase inhibitors (oseltamivir) are low.
2.Decreased sensitivity to mabaloxavir is rarely observed. In Japan, where usage is higher, the detection rate of the virus with reduced sensitivity to mabaloxavir is higher, as high as 45%；In addition, a decrease in sensitivity due to amino acid substitution has also been found in clinical trials, which is more common in 5-year-old children.
3.The current circulating influenza A viruses have high levels of resistance to amantadine and amantadine, and both drugs are ineffective against influenza B viruses and are not recommended.
In summary, oseltamivir is the first choice for the first choice and prevention of influenza in children, and oseltamivir is still sensitive to influenza viruses; If the flu season is prevalent, when a child is suspected of having the flu, oseltamivir phosphate can be used instead of looking at the flu test results. Oseltamivir phosphate** or prophylaxis against influenza is best used within 48 hours, but oseltamivir phosphate** and prophylaxis can be used at any time if influenza is diagnosed or if there is a clear history of exposure to influenza; Amantadine and amantadine ** are not recommended at this time.
This suggestion is basically consistent with the domestic expert consensus on the diagnosis of childhood influenza and **.
This article is excerpted from Yimaitong's "Latest AAP Guidelines: Oseltamivir - the Antiviral Drug of Choice for the [Prevention] [Treatment] of Influenza in Children".