[Practical pediatric aspects of palivizumab]

Palivizumab (Synagis) is a monoclonal antibody directed against the respiratory syncytial virus (RSV), for reducing mortality and morbidity in infants at risk of cardio-respiratory impairement due to bronchiolitis: 1. prematurity less than 28 weeks and less than 1 year of age; 2. between 28 and 32 weeks plus mechanical ventilation and less than 6 months of age; 3. chronic lung deficiency and less than 2 years of age; 4. congenital cardiopathy with either desaturation, pulmonary hypertension or cardiac failure. Another group of infants is those having a severe imnnunodeficiency. These infants are listed in a hospital recognized to have a competence in neonatal intensive care or a cardio-thoracic care program. The specialist in those disciplines prescribe the palivizumab which is delivered by the pharmacy of the competent hospital. The infant receives it by IM route at a dose of 15 mg/kg, monthly between October or November and February or March. Reduction of mortality and morbidity have been observed in the infants at risk. However, this costly pharmacological preventive approach needs to come after other simple preventive measures such as avoiding contact with potential carriers of nasal viruses and passive smoking, for bronchiolitis is not solely due to RSV.