Background Palivizumab is a monoclonal antibody that provides passive immunity against respiratory syncytial virus (RSV) and has very specific criteria for use that have changed recently. According to the literature data, the annual incidence of bronchiolitis is 7–20%, and the estimated hospitalisation rate is 2–5%.
Purpose To describe the use and effectiveness of palivizumab in the prophylaxis of RSV in the 2013–2014 campaign in a tertiary hospital.
Material and methods Retrospective observational study including children who received palivizumab between October 2013 and March 2014.
The variables collected were: sex, gestational age, age at the beginning of the vaccination campaign, number of doses, prescription criteria (A: children <2 years with bronchopulmonary disease who had required treatment in the last 6 months; B: children <2 years with haemodynamically significant congenital heart disease; C: gestational age ≤28 weeks and age ≤12 months; D: gestational age between 29 and 32 weeks and age ≤6 months; and E: gestational age between 32 and 35 weeks, age <10 weeks and a school-age brother/sister), number of hospitalisations for bronchiolitis and result of immunochromatographic test for the qualitative detection of RSV antigens in nasopharyngeal samples.
Data were obtained from the clinical history, laboratory data and the hospital pharmacy software.
Results Palivizumab was prescribed in 52 children (61.54% were male) with an average age of 3.82 ± 5.03 months at the beginning of treatment. The prescription criteria were: 13 criteria B (25.00%); 6 criteria C (11.54%); 13 criteria D (25.00%); and 20 criteria E (38.46%).
All patients received the recommended dosage and 84.62% received all prescribed doses.
Only 2 patients (3.85%) were hospitalised due to acute bronchiolitis, and only 1 (1.92%) had a positive RSV test; this patient had received only one dose of palivizumab 4 days before hospitalisation.
Conclusion Palivizumab has been effective in preventing RSV bronchiolitis in high risk patients and has been used under the established criteria of the Spanish Society of Neonatology for the campaign 2013–2014.
New criteria for palivizumab use are more restrictive to make treatment more cost effective.
More studies are needed to evaluate the effectiveness with current criteria.
References and/or Acknowledgements
Figueras-Aloy J, et al. Update of recommendations on the use of palivizumab as prophylaxis in RSV infections. An Pediatr (Barc)2015;82:199.e1-2
References and/or AcknowledgementsNo conflict of interest.
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