While oseltamivir (approved for infants ≥2 weeks of age) has now been used to treat children with influenza for nearly 20 years, its efficacy and safety remains controversial. The authors wanted to add new randomised controlled trials (RCT) to an updated meta-analysis. They identified five trials that included 2561 patients in the intent to treat (ITT) and 1598 in the intent to treat infected (ITTI) populations. Overall, they found that oseltamivir treatment significantly reduced the duration of illness in the ITTI population (restricted mean survival time [RMST] difference -17.6 hours, 95%CI -34.7 to -0.62 hours). In trials that enrolled patients without asthma, the difference was larger (RMST -29.9 hours, 95%CI -53.9 to -5.8 hours). The risk of otitis media was 34% lower in the ITTI population. The only adverse event seen was vomiting. Therefore treatment with oseltamivir does significantly reduce the duration of illness in children with influenza and lowered the risk of developing otitis media.
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