A nationwide study published in JAMA Pediatrics found that early antiviral treatment with oseltamivir is associated with significantly lower rates of intensive care unit admission among children hospitalized with influenza. Researchers analyzed data from more than 7,000 pediatric hospitalizations across 13 states and eight flu seasons from 2014 to 2023.
The study used the CDC-supported FluSurv-NET surveillance network, which captures laboratory-confirmed influenza hospitalizations. Unlike many earlier observational studies, this analysis accounted for the timing of symptom onset and when antiviral treatment began, using advanced statistical methods to strengthen the evidence.
Children who received oseltamivir early were 31% less likely to be admitted to an ICU compared with those who did not receive the antiviral. They also had shorter hospital stays. The protective effect was observed even when treatment started beyond the first two days of illness.
Senior author Suchitra Rao, MD, a professor of pediatrics at the University of Colorado Anschutz School of Medicine and an infectious disease specialist at Children's Hospital Colorado, said the findings reinforce the importance of treating hospitalized children with influenza as soon as possible.
National guidelines recommend antiviral treatment for children with suspected or confirmed influenza who are hospitalized, but the study notes that use of these medications among hospitalized children has declined in recent years.
The research represents one of the largest and most rigorous real-world evaluations of antiviral effectiveness in pediatric influenza to date. Its design addressed gaps in earlier studies that often lacked detailed timing data on symptom onset and treatment initiation.
The findings support current recommendations for prompt antiviral use in hospitalized children with influenza. The study was published in JAMA Pediatrics in 2026 (DOI: 10.1001/jamapediatrics.2026.3376).
Largest real-world study finds early flu antiviral treatment reduces ICU admissions in hospitalized children
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