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Appropriate prophylaxis with restrictive palivizumab regimen in preterm children in Sweden

L Navér1, M Eriksson, U Ewald

  • 1Department of Clinical Science, Division of Paediatrics, Karolinska University Hospital, Huddinge, Sweden. lars.naver@klinvet.ki.se

Acta Paediatrica (Oslo, Norway : 1992)
|October 30, 2004
PubMed

Insights

Swedish guidelines for palivizumab prophylaxis in premature infants were evaluated. Restrictive use of palivizumab (Synagis) for respiratory syncytial virus (RSV) prevention was found safe and effective in preterm infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Palivizumab (Synagis) is used for respiratory syncytial virus (RSV) prophylaxis in premature infants, but its high cost and efficacy have prompted debate.
  • National guidelines for palivizumab use were established in Sweden in 2000.

Purpose of the Study:

  • To evaluate the safety and effectiveness of the national Swedish guidelines for palivizumab use in preventing RSV in premature infants.

Main Methods:

  • A nationwide prospective study was conducted over two RSV seasons (2000-2002).
  • Paediatric departments reported palivizumab usage, indications, and hospital admissions for RSV in preterm infants (<36 weeks gestation, <2 years old).

Main Results:

  • 218 (3.8%) infants born before 36 weeks and 97 (5.4%) born before 33 weeks were hospitalized for RSV.
  • 16 (4.1%) of 390 infants receiving palivizumab were hospitalized with RSV; no deaths were reported.
  • Five children required mechanical ventilation.

Conclusions:

  • The restrictive Swedish palivizumab recommendations are considered safe.
  • Continued restrictive use of palivizumab is recommended, specifically for preterm infants under 1 year with chronic lung disease and active treatment.
Abstract

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