[Palivizumab for respiratory syncytial virus disease]

Palivizumab (Synagis, Abbott) is a humanized monoclonal antibody of IgG class currently used for prophylaxis of respiratory syncytial virus (RSV) infection. It neutralises the protein F of RSV, which allows the virus to penetrate inside the host cell and subsequently to form syncytia, causing clinical manifestations. Based on that, our aim was to assess if an early administration of palivizumab during RSV infection could positively modify the infection course, hence providing a therapeutic effect.

The study included eight infants hospitalized with a case history suggestive of severe RSV which made the use of oxygen therapy and, in five cases, mechanical ventilation necessary. The diagnosis was confirmed by the isolation of the virus in the nasopharyngeal aspirate; for all of them informed consent was obtained by the parents. All infants were treated with palivizumab (15 mg/kg i.m. in a single dose).

All infants showed a significant clinical improvement and a fast recovery, with a consequent precocious dismissal. After 7 days, 6 infants had a negative nasopharyngeal aspirate. Palivizumab administration at the onset of RSV infection seems to work as a therapy.

The limited number of the patients does not allow to formulate definitive conclusions but the present study suggests the usefulness of verifying these positive results through randomised controlled studies.