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Pediatric Nirmatrelvir/Ritonavir Prescribing Patterns During the COVID-19 Pandemic.
Bose-Brill, Seuli; Hirabayashi, Kathryn; Schwimmer, Emmanuel; Pajor, Nathan M; Rao, Suchitra; Mejias, Asuncion; Jhaveri, Ravi; Forrest, Christopher B; Bailey, L Charles; Christakis, Dimitri A; Thacker, Deepika; Hanley, Patrick C; Patel, Payal B; Cogen, Jonathan D; Block, Jason P; Prahalad, Priya; Lorman, Vitaly; Lee, Grace M.
Afiliación
  • Bose-Brill S; Combined Internal Medicine and Pediatrics Section, Division of General Internal Medicine, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio.
  • Hirabayashi K; Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Schwimmer E; Combined Internal Medicine and Pediatrics Section, Division of General Internal Medicine, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio.
  • Pajor NM; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
  • Rao S; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
  • Mejias A; Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
  • Jhaveri R; Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
  • Forrest CB; Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Bailey LC; Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Christakis DA; Center for Child Health, Behavior, and Development, Seattle Children's Hospital, Seattle, Washington.
  • Thacker D; Divisions of Cardiology.
  • Hanley PC; Endocrinology, Nemours Children's Hospital.
  • Patel PB; Center for Child Health, Behavior, and Development, Seattle Children's Hospital, Seattle, Washington.
  • Cogen JD; Center for Child Health, Behavior, and Development, Seattle Children's Hospital, Seattle, Washington.
  • Block JP; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts.
  • Prahalad P; Departments of Pediatrics (Endocrinology).
  • Lorman V; Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Lee GM; Pediatrics (Infectious Diseases), Stanford University School of Medicine, Stanford, California.
Hosp Pediatr ; 14(8): e341-e348, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-39076115
ABSTRACT

OBJECTIVES:

This study seeks to identify demographic and clinical factors prompting clinician prescribing of nirmatrelvir/ritonavir to pediatric patients for management of coronavirus disease 2019 (COVID-19) infection.

METHODS:

Patients aged 12 to 17 years with a COVID-19 infection and nirmatrelvir/ritonavir prescription during an outpatient clinical encounter within a PEDSnet-affiliated institution between January 2022 and August 2023 were identified using electronic health record data. A multivariate logistic regression analysis was used to estimate odds of nirmatrelvir/ritonavir prescription after adjusting for various factors.

RESULTS:

A total of 20 959 patients aged 12 to 17 years were diagnosed with a COVID-19 infection on the basis of an electronic health record-documented positive polymerase chain reaction or antigen test or diagnosis during an outpatient clinical visit. Of these patients, 408 received a nirmatrelvir/ritonavir prescription within 5 days of diagnosis. Higher odds of nirmatrelvir/ritonavir treatment were associated with having chronic or complex chronic disease (chronic odds ratio [OR] 2.50 [95% confidence interval (CI) 1.83-3.38]; complex chronic OR 2.21 [95% CI 1.58-3.08]). Among patients with chronic disease, each additional body system conferred 1.18 times higher odds of treatment (95% CI 1.10-1.26). Compared with non-Hispanic white patients, Hispanic patients (OR 0.61 [95% CI 0.44-0.83]) had lower odds of treatment.

CONCLUSIONS:

Children with chronic conditions are more likely than those without to receive nirmatrelvir/ritonavir prescriptions. However, nirmatrelvir/ritonavir prescribing to children with chronic conditions remains infrequent. Pediatric data concerning nirmatrelvir/ritonavir safety and effectiveness in preventing severe disease and hospitalization are critical optimizing clinical decision-making and use among children.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Ritonavir / Tratamiento Farmacológico de COVID-19 Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Hosp Pediatr Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Ritonavir / Tratamiento Farmacológico de COVID-19 Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Hosp Pediatr Año: 2024 Tipo del documento: Article