Abstract
AIM: In this study, we aimed to provide a comprehensive analysis of real-world implications for the therapeutic efficacy and safety of baloxavir marboxil, oseltamivir phosphate capsules and oseltamivir phosphate granules in the treatment of 160 Chinese children with influenza A. METHODS: This retrospective study included children aged 10-16 with influenza A treated at a hospital in Beijing between January 2023 and August 2024. Participants were categorised into three groups: oseltamivir capsule group (n = 56), oseltamivir granule group (n = 55) and baloxavir group (n = 49). Clinical characteristics, epidemiology, therapeutic effects (e.g., fever clearance time, total illness duration and curative rate), drug costs and adverse reactions were compared among groups. RESULTS: No significant differences were found in demographics or initial symptoms (p > 0.05). Fever clearance time and total illness duration were significantly shorter in the baloxavir group compared to the oseltamivir capsule group (both p < 0.01) and the oseltamivir granule group (p < 0.01, p < 0.05) mainly in children with high fever. While the total effective rates were similar across groups, baloxavir showed a notably higher curative rate (84%, 41/49) than oseltamivir capsules (45%, 25/56) and granules (49%, 27/55) (p < 0.01). Cost analysis indicated that oseltamivir capsules were the least expensive, with baloxavir being slightly less costly than oseltamivir granules (p < 0.01). CONCLUSIONS: Baloxavir marboxil exhibited superior efficacy in reducing fever and shortening the illness duration. Its single-dose regimen enhances compliance with antiviral therapy, although it remains a relatively more expensive option. In contrast, oseltamivir granules enabled more accurate dosing, while oseltamivir capsules were the most cost-effective treatment.