This systematic review and meta-analysis compared the efficacy and safety of baloxavir marboxil and oseltamivir in treating influenza in children. A comprehensive literature search was conducted across multiple databases, identifying five studies (four observational and one randomized controlled trial) with a pooled sample size of 2,261 patients. The analysis revealed that baloxavir marboxil significantly reduced the duration of fever compared to oseltamivir (mean difference: -13.49 hours, 95% CI: -23.75 to -3.24). However, there was no significant difference in the time to resolution of overall influenza symptoms between the two treatments (mean difference: -4.55 hours, 95% CI: -19.48 to 10.37). Safety analysis, though limited by available data, suggested a lower incidence of nausea and vomiting with baloxavir marboxil compared to oseltamivir. Both drugs demonstrated comparable safety profiles for other adverse events. These findings indicate that while both medications remain viable options for managing pediatric influenza, baloxavir marboxil may offer advantages in terms of rapid fever reduction and potentially fewer gastrointestinal side effects. However, the study highlights the need for more robust, large-scale randomized controlled trials focusing exclusively on pediatric populations to strengthen the evidence base. Clinicians should consider individual patient factors, local resistance patterns, and current guidelines when making treatment decisions. Future research should explore combination therapies and their potential to manage severe influenza cases in children and conduct more comprehensive safety assessments in pediatric populations.
Keywords: baloxavir; children; influenza; oseltamivir; review article.
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