A Phase 2 Study of Pimodivir (JNJ-63623872) in Combination With Oseltamivir in Elderly and Nonelderly Adults Hospitalized With Influenza A Infection: OPAL Study.

BACKGROUND: Both the elderly and individuals with comorbidities are at increased risk of developing influenza-related complications. Novel influenza antivirals are required, given limitations of current drugs (eg, resistance emergence and poor efficacy). Pimodivir is a first-in-class antiviral for influenza A under development for these patients. METHODS: Hospitalized patients with influenza A infection were randomized 2:1 to receive pimodivir 600 mg plus oseltamivir 75 mg or placebo plus oseltamivir 75 mg twice daily for 7 days in this phase 2b study. The primary objective was to compare pimodivir pharmacokinetics in elderly (aged 65-85 years) versus nonelderly adults (aged 18-64 years). Secondary end points included time to patient-reported symptom resolution. RESULTS: Pimodivir pharmacokinetic parameters in nonelderly and elderly patients were similar. Time to influenza symptom resolution was numerically shorter with pimodivir (72.45 hours) than placebo (94.15 hours). There was a lower incidence of influenza-related complications in the pimodivir group (7.9%) versus placebo group (15.6%). Treatment was generally well tolerated. CONCLUSIONS: No apparent relationship was observed between pimodivir pharmacokinetics and age. Our data demonstrate the need for a larger study of pimodivir in addition to oseltamivir to test whether it results in a clinically significant decrease in time-to-influenza-symptom alleviation and/or the frequency of influenza complications. CLINICAL TRIALS REGISTRATION: NCT02532283.

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment.

Prompt antiviral treatment has the potential to reduce influenza virus transmission to close contacts, but rigorous data on the magnitude of treatment effects on transmission are limited. Animal model data indicate that rapid reductions in viral replication after antiviral treatment reduce the risk of transmission. Observational and clinical trial data with oseltamivir and other neuraminidase inhibitors indicate that prompt treatment of household index patients seems to reduce the risk of illness in contacts, although the magnitude of the reported effects has varied widely across studies. In addition, the potential risk of transmitting drug-resistant variants exists with all approved classes of influenza antivirals. A controlled trial examining baloxavir treatment efficacy to reduce transmission, including the risk of transmitting virus with reduced baloxavir susceptibility, is currently in progress. If reduced transmission risk is confirmed, modeling studies indicate that early treatment could have major epidemiologic benefits in seasonal and pandemic influenza.

Clinical effectiveness of baloxavir marboxil against influenza in three seasons.

BACKGROUND: Previous reports have not clarified the difference in clinical efficacy between baloxavir and oseltamivir against influenza. METHODS: A prospective observational study was performed during 2017-2018, 2018-2019, and 2019-2020 influenza seasons. The primary endpoint of this study was to compare the duration of fever between patients who received baloxavir and those who received oseltamivir. RESULTS: A total of 235 influenza-infected patients (3-18 years of age), including 91 who received oseltamivir and 144 who received baloxavir, were enrolled. The proportions of influenza A(H3N2) virus, influenza A(H1N1)pdm09 virus, and influenza B virus-infected patients were 31.5%, 42.6%, and 26.0%, respectively. Patients who received oseltamivir were significantly younger than those who received baloxavir. Univariate analyses showed that the duration of fever was shorter with baloxavir than with oseltamivir against influenza virus overall, influenza A virus, influenza B virus, and influenza A(H1N1)pdm09 virus, but not for influenza A(H3N2) virus. In multivariate analyses, hazard ratios for influenza virus overall (0.53 [95% CI, 0.38-0.73]), influenza B virus (0.16 [95% CI, 0.07-0.41]), and influenza A(H1N1)pdm09 virus (0.55 [95% CI, 0.32-0.93]) were significantly lower in the patients who received baloxavir than those who received oseltamivir. However, the differences between influenza A virus and influenza A(H3N2) virus were not significant between the two groups. CONCLUSION: For influenza virus overall, influenza B virus, and influenza A(H1N1)pdm09 virus, baloxavir treatment resulted in shorter duration of fever than oseltamivir treatment, but not for influenza A virus and influenza A(H3N2) virus.

Prophylactic oseltamivir during major seasonal influenza H1N1 outbreak might reduce both H1N1 and associated pulmonary aspergillosis in children undergoing haploidentical transplantation.

Following a major seasonal outbreak of H1N1 influenza in 2018 September, prophylactic oseltamivir for six months was initiated in children undergoing haploidentical HCT with regular monitoring for influenza and other respiratory virus infections. Influenza was not detected in 22 children undergoing prophylaxis, compared to 8 H1N1 infections in 21 adults without prophylaxis (P = .01). Four children on prophylaxis were detected to have other respiratory viruses, compared to 8 in those without prophylaxis. Invasive pulmonary aspergillosis (IPA) was observed only in association with H1N1 (4/8 with H1N1 vs 0/35 without H1N1, P = .001) and was thus lower in the prophylaxis group (P = .04). The overall incidence of episodes of respiratory illness and hospital stay were also lower in those on prophylaxis (P = .001). There were no untoward side effects associated with prophylactic oseltamivir. Prophylactic oseltamivir was safe and effective in prevention of H1N1 infection and subsequent IPA in children at-risk, early after haploidentical HCT.

Pediatric heart transplantation from an influenza B-positive donor.

As heart transplantation demand is increasing without subsequent growth of the donor pool, need for expansion of acceptance criteria is paramount, particularly when considering critically ill, highly sensitized patients. We present a case report of a pediatric heart transplant recipient of an organ refused by 197 prior potential recipients due to the donor being infected with influenza virus. We perform a literature review of recent solid organ transplant cases from influenza-positive donors and conclude that the donor pool may be expandable by allowing donors with treatable infections to be included.

[Clinical efficacy observation of atomization inhalation combined with oral administration of oseltamivir in 4 cases with H7N9 avian influenza].

Objective: To investigate the clinical efficacy of atomization inhalation combined with oral administration of oseltamivir in treatment of human infection with H7N9 avian influenza. Methods: To analyze the clinical data of 4 patients hospitalized from Mar 6th 2017 to Apr 12th 2017 with avian influenza(H7N9) infection treated by conventional therapy(oseltamivir, 150 mg, po, Bid) plus with oseltamivir inhalation(75 mg dissolved in 20 ml N. S, Bid) and administered with antibacterial treatment, blood purification and immunomodulators. Results: Undergoing these comprehensive therapies, Bronchial lavage fluid and pharynx of 1 case was negative for H7N9 RNA after 24 h, 2 cases negative for H7N9 after 3 d and 1 case negative for H7N9 RNA after 4 d. All patients were cured and discharged without any complications. Conclusions: Aseltamivir inhalation combined with oral treatment can significantly shorten the time of virus nucleic acid turning negative, improve the efficacy of anti avian influenza virus H7N9, and increase the cure rate of avian influenza H7N9 infection patients.

Influenza in the Emergency Department: Vaccination, Diagnosis, and Treatment: Clinical Practice Paper Approved by American Academy of Emergency Medicine Clinical Guidelines Committee.

BACKGROUND: Influenza is an acute respiratory virus that results in significant worldwide morbidity and mortality each year. As emergency physicians, we are often the first to encounter patients with seasonal influenza. It is therefore critical that we draw on the most recent and relevant research when we make clinical decisions regarding the diagnosis, treatment, and prophylaxis of this disease. METHODS: A MEDLINE literature search from August 2009 to August 2015 was performed using the keywords influenza vaccination efficacy AND systematic, influenza AND rapid antigen testing, and Oseltamivir AND systematic, while limiting the search to human studies written in the English language. General review articles and case reports were omitted. Each of the selected articles then underwent a structured review. RESULTS: We identified 163 articles through our literature search, of which 68 were found to be relevant to our clinical questions. These studies then underwent a rigorous review from which recommendations were given. CONCLUSIONS: Influenza vaccine efficacy continues to range between 40% and 80%. Vaccination has the potential to decrease disease severity and is recommended for individuals older than 6 months of age. If resources permit, vaccination can be offered to patients presenting to the emergency department. Rapid antigen detection for influenza is a simple bedside test with high specificity, but generally low sensitivity. If a patient presents with a syndrome consistent with influenza and has negative rapid antigen detection, they should either receive a confirmatory reverse transcriptase polymerase chain reaction or be treated as if they have influenza. Treatment with neuraminidase inhibitors can decrease the duration of influenza and is recommended in hospitalized patients, or in those with high risk of complications.

Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial.

BACKGROUND: Echinacea has antiviral activity against influenza viruses in vitro and has traditionally been used for treatment of colds and flu. OBJECTIVES: This randomized, double-blind, double-dummy, multicenter, controlled clinical trial compared a new echinacea formulation with the neuraminidase inhibitor oseltamivir, the gold standard treatment for influenza. METHODS: Following informed consent, 473 patients with early influenza symptoms (≤48 hours) were recruited in primary care in the Czech Republic and randomized to either 5 days of oseltamivir followed by 5 days of placebo, or 10 days of an Echinacea purpurea-based formulation called Echinaforce Hotdrink (A. Vogel Bioforce AG, Roggwil, Switzerland). The proportion of recovered patients (influenza symptoms rated as absent or mild in the evening) was analyzed for noninferiority between treatment groups using a generalized Wilcoxon test with significance level α = 0.05 (2-sided) and using a CI approach in the per-protocol sample. RESULTS: Recovery from illness was comparable in the 2 treatment groups at 1.5% versus 4.1% after 1 day, 50.2% versus 48.8% after 5 days, and 90.1% versus 84.8% after 10 days of treatment with Echinaforce Hotdrink and oseltamivir, respectively. Noninferiority was demonstrated for each day and overall (95% CI, 0.487-0.5265 by generalized Wilcoxon test). Very similar results were obtained in the group with virologically confirmed influenza virus infections and in a retrospective analysis during the peak influenza period. The incidence of complications was lower with Echinaforce Hotdrink than with oseltamivir (2.46% vs 6.45%; P = 0.076) and fewer adverse events (particularly nausea and vomiting) were observed with Echinaforce Hotdrink. CONCLUSIONS: Echinaforce Hotdrink is as effective as oseltamivir in the early treatment of clinically diagnosed and virologically confirmed influenza virus infections with a reduced risk of complications and adverse events. It appears to be an attractive treatment option, particularly suitable for self-care. Clinical trial identifier: Eudra-CT: 2010-021571-88. (Curr Ther Res Clin Exp. 2015; 77:66-72).

Comparative effectiveness of oseltamivir versus peramivir for hospitalized children (aged 0-5 years) with influenza infection.

OBJECTIVES: The effectiveness of oseltamivir versus peramivir in children infected with influenza remains unclear. This study aimed to evaluate their effectiveness in young children (aged 0-5 years) infected with severe influenza A virus (IAV) or influenza B virus (IBV). METHODS: We analyzed a cohort of 1662 young children with either IAV (N = 1095) or IBV (N = 567) who received oseltamivir or peramivir treatment from January 1, 2018 to March 31, 2022. Propensity score matching methods were applied to match children who were oseltamivir-treated versus peramivir-treated. RESULTS: Children who were IAV-infected and IBV-infected shared similar features, such as influenza-associated symptoms and comorbidities at baseline. Among children infected with IAV with bacterial coinfection, the recovery rate was significantly greater in children treated with oseltamivir than in children treated with peramivir (15.6% vs 4.4%, P = 0.01). The median duration of hospitalization was also shorter in children treated with oseltamivir. Among children infected with IAV without bacterial coinfection, the recovery rate was greater in children treated with oseltamivir than in children treated with peramivir (21.1% vs 3.7%, P = 0.002). However, oseltamivir and peramivir offered similar recovery rates and duration of hospitalization (P >0.05 for both) among children infected with IBV. CONCLUSION: Oseltamivir and peramivir exhibit similar effectiveness in young children with severe influenza B, whereas oseltamivir demonstrated improved recovery and shorter hospitalization in the treatment of severe influenza A in hospitalized children.

Prophylactic Treatment with Baloxavir Protects Mice from Lethal Infection with Influenza A and B Viruses.

Influenza remains a worldwide health concern. Antiviral drugs are considered as one of the useful options for its prevention as a complementary measure to vaccination. Baloxavir acid selectively inhibits the cap-dependent endonuclease of influenza viruses and exhibits marked viral titre reduction in patients. Here, we describe the prophylactic potency of baloxavir acid against lethal infection with influenza A and B viruses in mice. BALB/c mice were subcutaneously administered once with baloxavir acid suspension, or orally administered once daily for 10 days with oseltamivir phosphate solution at human relevant doses. Next, the mice were intranasally inoculated with A/PR/8/34 (H1N1) or B/Hong Kong/5/72 strain at 24 to 96 h after the initial dosing. Prophylactic treatment with the antiviral drugs significantly reduced the lung viral titres and prolonged survival time. In particular, baloxavir acid showed a greater suppressive effect on lung viral titres compared to oseltamivir phosphate. In this model, baloxavir acid maintained significant prophylactic effects against influenza A and B virus infections when the plasma concentration at the time of infection was at least 0.88 and 3.58 ng/mL, respectively. The significant prophylactic efficacy observed in our mouse model suggests the potential utility of baloxavir marboxil for prophylaxis against influenza in humans.

Oseltamivir-Associated Supraventricular Tachycardia in an Infant.

Oseltamivir is a neuraminidase inhibitor that is labeled for prophylaxis and treatment of influenza. We describe a previously healthy 4-month-old infant who tested positive for influenza A and was started on oseltamivir. One hour after receiving his first dose of oseltamivir, the infant had a diaphoretic episode and appeared grey and clammy. The infant was subsequently seen by the primary care physician and referred for admission to the hospital. Approximately 40 minutes after the second dose of oseltamivir in the hospital, the infant's heart rate rose to greater than 300 bpm. An electrocardiogram was suggestive of supraventricular tachycardia. At the time of the event, the infant received 2 doses of adenosine, and oseltamivir was discontinued prior to transfer to a tertiary facility for a higher level of care.

Oseltamivir for coronavirus illness: post-hoc exploratory analysis of an open-label, pragmatic, randomised controlled trial in European primary care from 2016 to 2018.

BACKGROUND: Patients infected with the novel coronavirus (SARS-CoV-2) are being treated empirically with oseltamivir, but there is little evidence from randomised controlled trials to support the treatment of coronavirus infections with oseltamivir. AIM: To determine whether adding oseltamivir to usual care reduces time to recovery in symptomatic patients who have tested positive for coronavirus (not including SARS-CoV-2). DESIGN AND SETTING: Exploratory analysis of data from an open-label, pragmatic, randomised controlled trial during three influenza seasons, from 2016 to 2018, in primary care research networks, in 15 European countries. METHOD: Patients aged ≥1 year presenting to primary care with influenza-like illness (ILI), and who tested positive for coronavirus (not including SARS-CoV-2), were randomised to usual care or usual care plus oseltamivir. The primary outcome was time to recovery defined as a return to usual activities, with minor or absent fever, headache, and muscle ache. RESULTS: Coronaviruses (CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63) were identified in 308 (9%) out of 3266 randomised participants in the trial; 153 of these were allocated to usual care and 155 to usual care plus oseltamivir; the primary outcome was ascertained in 136 and 147 participants, respectively. The median time to recovery was shorter in patients randomised to oseltamivir: 4 days (interquartile range [IQR] 3-6) versus 5 days (IQR 3-8; hazard ratio 1.31; 95% confidence interval = 1.03 to 1.66; P = 0.026). CONCLUSION: Primary care patients with ILI testing positive for coronavirus (not including SARS-CoV-2) recovered sooner when oseltamivir was added to usual care compared with usual care alone. This may be of relevance to the primary care management of COVID-19.

Healthcare professionals' queries on oseltamivir and influenza in Finland 2011-2016-Can we detect influenza epidemics with specific online searches?

BACKGROUND: Healthcare professionals (HCPs) search medical information during their clinical work using Internet sources. In Finland, Physician's Databases (PD) serve as an Internet medical portal aimed at HCPs. Influenza epidemics appear seasonal outbreaks causing public health concern. Oseltamivir can be used to treat influenza. Little is known about HCPs' queries on oseltamivir and influenza from dedicated online medical portals and whether queries could be used as an additional source of information for disease surveillance when detecting influenza epidemics. METHODS: We compared HCPs' queries on oseltamivir and influenza from PD to influenza diagnoses from the primary healthcare register in Finland 2011-2016. The Moving Epidemic Method (MEM) calculated the starts of influenza epidemics. Laboratory reports of influenza A and influenza B were assessed. Paired differences compared queries, diagnoses, and laboratory reports by using starting weeks. Kendall's correlation test assessed the season-to-season similarity. RESULTS: We found that PD and the primary healthcare register showed visually similar patterns annually. Paired differences in the mean showed that influenza epidemics based on queries on oseltamivir started earlier than epidemics based on diagnoses by -0.80 weeks (95% CI: -1.0, 0.0) with high correlation (τ = 0.943). Queries on influenza preceded queries on oseltamivir by -0.80 weeks (95% CI: -1.2, 0.0) and diagnoses by -1.60 weeks (95% CI: -1.8, -1.0). CONCLUSIONS: HCPs' queries on oseltamivir and influenza from Internet medical databases correlated with register diagnoses of influenza. Therefore, they should be considered as a supplementary source of information for disease surveillance when detecting influenza epidemics.

Awareness and acceptance of H1N1 vaccination among physicians: Experience of 2017 vaccination campaign.

CONTEXT: India experienced pandemic phase of H1N1 in May 2009 to December 2010. The postpandemic phase went on from January 2011 to December 2014. As per the WHO, all countries should immunize their health-care workers as a first priority to protect the essential health infrastructure. AIMS: The aim of the study is to assess the level of awareness and acceptance of influenza vaccine among physicians and also the perception of physicians regarding H1N1 infection. This study also examined time of vaccine administration in relation with efficacy concerns based on literature. SETTINGS AND DESIGN: A vaccination campaign was conducted for all health-care workers of Seth GSMC and KEM Hospital, Mumbai, in the month of July 2017 based on which a cross-sectional observational study was conducted among the physicians of the same institute. METHODS: After ethical clearance, a prevalidated pretested survey based on a pilot survey of 20 physicians was distributed among physicians, which was based on the awareness and acceptance of H1N1 vaccination among physicians and perception of H1N1 infection. Effective sample size was 272. STATISTICAL ANALYSIS USED: Descriptive statistics and Chi-square test were generated for the survey responses. All the continuous variables were reported as mean, median, and range. Categorical variables were reported as tables and pie charts. P < 0.05 was taken as significant. Data analysis was done with SPSS version 21. RESULTS: The overall vaccine compliance was 29.8%. This study has found that area of work, deficiency in knowledge about adverse effect of vaccine, misconceptions regarding vaccine, and concerns about efficacy and duration of vaccine are the important factors which lead to decreased vaccine compliance. Furthermore, it is found during the study that timing of vaccination was not given due importance as considering the epidemiological pattern. CONCLUSIONS: More emphasis should be given to education sessions and counseling of physicians regarding H1N1 vaccination and oseltamivir therapy. At administrative level, more focus should be given on timing of vaccination and other logistics. Vaccine campaigns should be conducted ideally 1 month before expected rise in cases. Quadrivalent vaccine would be more appropriate over trivalent based on epidemiology of infection in India.

The Prophylactic Effect of Anti-influenza Agents for an Influenza Outbreak in a University Hospital.

Objective From November 24 to December 9, 2013, an outbreak of the influenza (flu) A (H3) virus occurred in a tertiary-care university hospital (1,014 beds). We herein report the prophylactic effect of anti-flu agents for controlling the flu outbreak. Methods We administered pre- or post-exposure prophylaxis with anti-flu agents in flu outbreak. To test the effectiveness of prophylaxis in a flu outbreak, we used the posterior mean of the reproductive value during the pre- and post-intervention period. We also simulated the probability distribution of new flu cases. We performed an analysis to quantify the strength of the intervention effect. Results A total of 97 people were diagnosed with flu before the intervention, and 7 were diagnosed after the intervention. A molecular analysis of the flu virus revealed that this outbreak was due to the flu A (H3) virus. A total of 3,702 people received prophylaxis. There was a significant reduction in the reproductive value from 1.89 [95% confidence interval (CI), 1.59 to 2.24] to 0.65 (95% CI, 0.02 to 1.00) after the intervention (p<0.001). Conclusion Prophylaxis with anti-flu agents, along with prompt identification and isolation of infected individuals, was effective in reducing the impact of a flu outbreak in a hospital.

Control of an H1N1 outbreak in a correctional facility in central Taiwan.

BACKGROUND: Controlling the outbreak of H1N1 in correctional facilities is difficult due to the inevitable close and prolonged contact between inmates. The current study reports an H1N1 outbreak in a correction facility and investigates the effectiveness of oseltamivir to control the spread of H1N1. METHODS: All 2690 inmates at the prison received medical service from a single hospital. A list of patients with a diagnosis of influenza was compiled based on medical diagnoses with respiratory symptoms during the outbreak period. The outbreak was then investigated using both chart review and questionnaires. RESULTS: In the 4-week outbreak period, 24.6% (663/2690) of inmates experienced influenza-associated symptoms, 50.5% (335/663) fulfilled the criteria for influenza-like illness (ILI) with fever, and the overall attack rate of ILI was 12.8%. Twelve inmates were admitted for complicated influenza, and three of them experienced respiratory failure. Oseltamivir was provided at the end of the 2nd week, and the effectiveness of oseltamivir in the 1004 inmates from seven major sections in the prison was analyzed. The ILI incidence rate reduced from 12.6 ± 4.1% between the 1st and 2nd weeks to 4.8 ± 2.4% between the 3rd and 4th weeks (p = 0.018) after the oseltamivir intervention. In the 878 uninfected inmates 47.0% (413/878) of inmates received prophylactic oseltamivir at the end of the 2nd week, the incidence of ILI was lower than those without prophylaxis (6.2% versus 2.4%; p = 0.013). CONCLUSION: H1N1 influenza spread rapidly in the correctional facility. The use of oseltamivir may be a practical intervention to control an H1N1 outbreak an enclosed environment such as this.

[Efficacy and safety of oseltamivir in children with suspected influenza: a multicenter randomized open-label trial].

Objective: To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children. Method: A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children's Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children's Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days. Result: No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting). Conclusion: The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.