Background. Influenza is characterized by severe course and causes significant damage to public health. Patients at risk of developing influenza complications require special attention in routine clinical practice. In this regard, a comparative assessment of the effect of antiviral influenza treatment on the incidence of bacterial complications, adverse events and duration of the disease in a high-risk groups is still relevant. Methods. A multicenter, non-interventional, observational study was conducted to study the effect of antiviral treatment on the incidence of influenza complications in the epidemic season 2023-2024 in 2005 outpatients from risk groups receiving oseltamivir, umifenovir, kagocel or imidazolyl ethanamide pentanedioic acid. Results. Bacterial complications of influenza developed in 18.87% among high risk out-patients, 17.41% was required antibacterial therapy. The hospitalization rate was 1.24%, and the mean duration of the disease was 8 days. The rate of bacterial complications in the groups was: oseltamivir – 18.96%, umifenovir – 12.17%, kagocel – 22.00%, imidazolyl ethanamide pentanedioic acid –22.64%. Adverse events were registered in 4.76% of patients, most of which 91.67% complained of gastrointestinal disorders, and only in 8.33% cases complaints were related to allergic reactions. The incidence of adverse events was statistically significantly higher in the oseltamivir group versus other treatments. Conclusions. Etiotropic drugs oseltamivir and umifenovir used in the treatment of influenza patients with a high risk of complications showed comparable efficacy in their impact on the incidence of bacterial complications and the duration of the disease and thus may be recommended as agents of choice for treatment of patients with influenza.