For children admitted with suspected influenza, treatment is usually started on clinical grounds without waiting for a test result, because benefit is greatest when given early. Oseltamivir is dosed by weight in children over one year and by age and weight in infants, and the oral suspension makes dosing straightforward.
Vomiting is the commonest side effect and is reduced by giving it with food. Children with asthma, neurological disease or other chronic conditions are at higher risk of complications and are among those who most need early treatment.
- Start oseltamivir for admitted children with suspected influenza without waiting for confirmation.
- Dose by weight using the oral suspension, checking the infant dosing schedule for those under one year.
- Give it with food to reduce nausea and vomiting.
- Prioritise children with asthma, neurological disease or immunosuppression for early treatment.
- Admission more than 48 hours after symptom onset is not, on its own, a reason to withhold treatment.
Why it matters
Antiviral use in admitted children has been falling despite the recommendations.
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