{"doi":"10.1093/cid/ciac606","title":"Guideline-Concordant Antiviral Treatment in Children at High Risk for Influenza Complications","abstract":"BACKGROUND: National guidelines recommend antiviral treatment for children with influenza at high risk for complications regardless of symptom duration. Little is known about concordance of clinical practice with this recommendation. METHODS: We performed a cross-sectional study of outpatient children (aged 1-18 years) at high risk for complications who were diagnosed with influenza during the 2016-2019 influenza seasons. High-risk status was determined using an existing definition that includes age, comorbidities, and residence in a long-term care facility. The primary outcome was influenza antiviral dispensing within 2 days of influenza diagnosis. We determined patient- and provider-level factors associated with guideline-concordant treatment using multivariable logistic regression. RESULTS: Of the 274 213 children with influenza at high risk for influenza complications, 159 350 (58.1%) received antiviral treatment. Antiviral treatment was associated with the presence of asthma (aOR, 1.13; 95% confidence interval [CI], 1.11-1.16), immunosuppression (aOR, 1.10; 95% CI, 1.05-1.16), complex chronic conditions (aOR, 1.04; 95% CI, 1.01-1.07), and index encounter in the urgent care setting (aOR, 1.3; 95% CI, 1.26-1.34). Factors associated with decreased odds of antiviral treatment include age 2-5 years compared with 6-17 years (aOR, 0.95; 95% CI, .93-.97), residing in a chronic care facility (aOR, .61; 95% CI, .46-.81), and index encounter in an emergency department (aOR, 0.66; 95% CI, .63-.71). CONCLUSIONS: Among children with influenza at high risk for complications, 42% did not receive guideline-concordant antiviral treatment. Further study is needed to elucidate barriers to appropriate use of antivirals in this vulnerable population.","journal":"Clinical Infectious Diseases","year":2022,"id":254573,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9605,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":479764,"name":"Matt Hall","orcid":"0000-0001-7778-5887","position":1,"is_corresponding":false},{"id":404187,"name":"James A. Feinstein","orcid":"0000-0003-3074-8805","position":2,"is_corresponding":false},{"id":901695,"name":"Kathryn E. Kyler","orcid":"0000-0002-5631-2228","position":3,"is_corresponding":false},{"id":91698,"name":"Samir S. Shah","orcid":"0000-0001-7902-7000","position":4,"is_corresponding":false},{"id":707531,"name":"Sonya Tang Girdwood","orcid":"0000-0001-7737-8499","position":5,"is_corresponding":false},{"id":301924,"name":"Jennifer L. Goldman","orcid":"0000-0001-6628-8949","position":6,"is_corresponding":false},{"id":105907,"name":"Carlos G. Grijalva","orcid":"0000-0002-2329-7797","position":7,"is_corresponding":false},{"id":328314,"name":"Derek J. Williams","orcid":"0000-0003-0295-1240","position":8,"is_corresponding":false},{"id":320779,"name":"James W. Antoon","orcid":"0000-0001-6188-2658","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":null,"created_at":"2026-07-19T00:25:08.518416Z","pmid":"35867691","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}