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Influenza diagnosis and treatment in children: a review of studies on clinically useful tests and antiviral treatment for influenza.
Pediatr Infect Dis J. 2003 Feb; 22(2):164-77.PI

Abstract

BACKGROUND

Prompt testing for influenza can help guide clinical management of patients with suspected influenza. Three antiviral medications, amantadine, oseltamivir and zanamivir, are approved for treatment of influenza in children. Rimantadine and ribavirin have also been used.

OBJECTIVES

To review the published evidence on clinically useful diagnostic tests and antiviral treatment for influenza virus infections in children.

METHODS

Studies published from 1966 through September 2002 were reviewed on clinical diagnosis, immunofluorescence and rapid influenza tests and on antiviral treatment of influenza virus infections among pediatric populations.

RESULTS

No studies assessed the accuracy of clinical diagnosis of influenza in children compared with viral culture. Compared with viral culture, direct immunofluorescence antibody and indirect immunofluorescence antibody tests for influenza had fair to moderate median sensitivities and high median specificities, whereas rapid influenza diagnostic tests had moderate median sensitivities and moderately high median specificities. No randomized, placebo-controlled studies were found of amantadine or rimantadine for treatment of influenza A. In a few separate controlled studies, oseltamivir, zanamivir and ribavirin each reduced symptom duration of influenza compared with placebo.

CONCLUSIONS

Additional data are needed about the accuracy of clinical diagnosis of influenza in children. Although direct immunofluorescence antibody staining, indirect immunofluorescence antibody staining and rapid tests are moderately to reasonably accurate in detecting influenza virus infections in children, physicians should use clinical judgment and local surveillance data about circulating influenza viruses when interpreting test results. Further controlled studies of the efficacy, adverse effects and emergence of antiviral resistance during treatment of influenza are needed for all of the antiviral drugs.

Authors+Show Affiliations

Influenza Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. tukeyi@cdc.gov

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12586981

Citation

Uyeki, Timothy M.. "Influenza Diagnosis and Treatment in Children: a Review of Studies On Clinically Useful Tests and Antiviral Treatment for Influenza." The Pediatric Infectious Disease Journal, vol. 22, no. 2, 2003, pp. 164-77.
Uyeki TM. Influenza diagnosis and treatment in children: a review of studies on clinically useful tests and antiviral treatment for influenza. Pediatr Infect Dis J. 2003;22(2):164-77.
Uyeki, T. M. (2003). Influenza diagnosis and treatment in children: a review of studies on clinically useful tests and antiviral treatment for influenza. The Pediatric Infectious Disease Journal, 22(2), 164-77.
Uyeki TM. Influenza Diagnosis and Treatment in Children: a Review of Studies On Clinically Useful Tests and Antiviral Treatment for Influenza. Pediatr Infect Dis J. 2003;22(2):164-77. PubMed PMID: 12586981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza diagnosis and treatment in children: a review of studies on clinically useful tests and antiviral treatment for influenza. A1 - Uyeki,Timothy M, PY - 2003/2/15/pubmed PY - 2003/4/12/medline PY - 2003/2/15/entrez SP - 164 EP - 77 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 22 IS - 2 N2 - BACKGROUND: Prompt testing for influenza can help guide clinical management of patients with suspected influenza. Three antiviral medications, amantadine, oseltamivir and zanamivir, are approved for treatment of influenza in children. Rimantadine and ribavirin have also been used. OBJECTIVES: To review the published evidence on clinically useful diagnostic tests and antiviral treatment for influenza virus infections in children. METHODS: Studies published from 1966 through September 2002 were reviewed on clinical diagnosis, immunofluorescence and rapid influenza tests and on antiviral treatment of influenza virus infections among pediatric populations. RESULTS: No studies assessed the accuracy of clinical diagnosis of influenza in children compared with viral culture. Compared with viral culture, direct immunofluorescence antibody and indirect immunofluorescence antibody tests for influenza had fair to moderate median sensitivities and high median specificities, whereas rapid influenza diagnostic tests had moderate median sensitivities and moderately high median specificities. No randomized, placebo-controlled studies were found of amantadine or rimantadine for treatment of influenza A. In a few separate controlled studies, oseltamivir, zanamivir and ribavirin each reduced symptom duration of influenza compared with placebo. CONCLUSIONS: Additional data are needed about the accuracy of clinical diagnosis of influenza in children. Although direct immunofluorescence antibody staining, indirect immunofluorescence antibody staining and rapid tests are moderately to reasonably accurate in detecting influenza virus infections in children, physicians should use clinical judgment and local surveillance data about circulating influenza viruses when interpreting test results. Further controlled studies of the efficacy, adverse effects and emergence of antiviral resistance during treatment of influenza are needed for all of the antiviral drugs. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/12586981/Influenza_diagnosis_and_treatment_in_children:_a_review_of_studies_on_clinically_useful_tests_and_antiviral_treatment_for_influenza_ L2 - https://doi.org/10.1097/01.inf.0000050458.35010.b6 DB - PRIME DP - Unbound Medicine ER -