Tagarro Alfredo, Cruz-Cañete Marta, Otheo Enrique, Launes Cristian, Couceiro José Antonio, Pérez Carlos, Alfayate Santiago
Servicio de Pediatría, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Grupo de Investigación Traslacional en Enfermedades Infecciosas Pediátricas, Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Universidad Europea de Madrid, Madrid, España.
Servicio de Pediatría, Hospital de Montilla, Agencia Sanitaria Hospital Alto Guadalquivir, Montilla, Córdoba, España.
An Pediatr (Engl Ed). 2019 May;90(5):317.e1-317.e8. doi: 10.1016/j.anpedi.2019.01.009. Epub 2019 Feb 21.
Influenza is a generally a benign disease, but occasionally it can cause serious complications. There is controversy about the benefits of antiviral treatment.
To provide some recommendations on the treatment with oseltamivir in paediatric patients with influenza, based on the best data available and valid in our environment.
The Respiratory Infections Group of the Spanish Society of Paediatric Infectious Diseases carried out a review of the literature. The findings were analysed using the GRADE methodology, and recommendations were made.
The systematic use of diagnostic tests for influenza in the outpatient setting, or in the emergency room, in immunocompetent patients with a compatible clinical picture is not recommended. If the aim is to prevent serious events, the use of antivirals is not recommended for the vast majority of healthy and asthmatic patients with influenza or suspected seasonal flu. The systematic use of oseltamivir in patients admitted to hospital with influenza is not recommended. Oseltamivir treatment is recommended in any patients with influenza and pneumonia or severe illness, and critically ill patients, especially during the first 48hours of illness. The treatment of patients with risk factors is recommended, considering their underlying disease. Influenza vaccination, together with basic isolation measures, continue to be the main tool in the prevention of influenza.
In some situations, there are sufficient data to issue clear recommendations. In other situations, the data are incomplete, and only allows weak recommendations.
流感通常是一种良性疾病，但偶尔会引发严重并发症。关于抗病毒治疗的益处存在争议。
基于我们环境中可得且有效的最佳数据，就流感患儿使用奥司他韦治疗提供一些建议。
西班牙儿科传染病学会呼吸道感染小组对文献进行了综述。采用GRADE方法对研究结果进行分析并提出建议。
不建议在门诊或急诊室对临床症状相符的免疫功能正常患者常规使用流感诊断检测。如果目的是预防严重事件，对于绝大多数患流感或疑似季节性流感的健康及哮喘患者，不建议使用抗病毒药物。不建议对住院流感患者常规使用奥司他韦。对于任何患有流感和肺炎或重症的患者以及危重症患者，建议使用奥司他韦治疗，尤其是在发病的头48小时内。考虑到患者的基础疾病，建议对有危险因素的患者进行治疗。流感疫苗接种以及基本隔离措施仍然是预防流感的主要手段。
在某些情况下，有足够的数据可给出明确建议。在其他情况下，数据不完整，仅能给出弱推荐。
