Trends of neuraminidase inhibitors use in children with influenza related respiratory infections.

BACKGROUND: Neuraminidase inhibitors are recommended for children hospitalized with influenza-related respiratory infections, and oseltamivir is the first choice of treatment in most situations. However, little is known regarding the recent trend in using neuraminidase inhibitors and their difference in health economy. The aim of this study was to reveal recent trends in neuraminidase inhibitor use and compare hospitalization costs across different treatment regimens.

METHODS: We retrospectively obtained the hospital discharge records of inpatients under 18 years of age with a diagnosis of influenza-related respiratory infections using a national inpatient database in Japan. We excluded patients with chronic medical conditions from the analyses. Multivariable mixed effects regression models were used to investigate the recent treatment trends and healthcare costs.

RESULTS: We identified 27 771 inpatients with influenza-related respiratory infections. The proportions of neuraminidase inhibitor use increased from 62.6% in 2010 to 71.8% in2014 (Ptrend  < 0.001). Correspondingly, the proportions of peramivir use showed an upward trend, ranging from 31.4% to 57.4% (Ptrend  < 0.001). In contrast, proportions of oseltamivir and zanamivir use decreased from 26.1% to 12.1% and from 4.9% to 1.5%, respectively (Ptrend  < 0.001). Laninamivir use did not change over the period. Total hospitalization costs were higher in the peramivir group than in the oseltamivir group (adjusted difference, $84.3; 95%CI, $70.7-$98.4).

CONCLUSIONS: We observed an increasing trend in peramivir use and decreasing trends in use of oseltamivir and zanamivir. Treatment with peramivir required higher hospitalization costs.