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Improving the prescribing of palivizumab

Simone Trist1,2, Emily Horsley1,2, Hala Katf1,2

  • 1Sydney Children's Hospital Network, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|June 5, 2018
PubMed

Insights

Palivizumab use in high-risk children for respiratory syncytial virus (RSV) often deviates from guidelines. A streamlined process improved adherence but requires further refinement for optimal effectiveness in preventing severe RSV disease.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Palivizumab is a monoclonal antibody used to prevent respiratory syncytial virus (RSV) in high-risk children.
  • Suboptimal prescribing and adherence to guidelines for palivizumab have been reported.
  • Evaluating palivizumab utilization in Australian pediatric hospitals is crucial for improving patient outcomes.

Purpose of the Study:

  • To review the utilization and effectiveness of palivizumab in two tertiary pediatric hospitals.
  • To assess the impact of a streamlined individual patient use (IPU) pro forma on palivizumab prescribing practices.
  • To identify areas for improvement in palivizumab administration and adherence to best-practice guidelines.

Main Methods:

  • Retrospective review of children prescribed palivizumab between January 2013 and December 2014.
  • Comparison with children admitted to pediatric intensive care units (PICUs) with RSV infection.
  • Implementation and review of a streamlined IPU pro forma at one hospital in 2015.

Main Results:

  • Prior to the intervention, 32% of palivizumab recipients at one hospital did not meet guidelines, and 32% did not complete the course.
  • None of the eligible children admitted to PICU for RSV received palivizumab prior to admission.
  • After the streamlined IPU implementation, 27% of recipients still did not meet guidelines, and 63% did not complete the course.

Conclusions:

  • Palivizumab is frequently prescribed without adherence to best-practice guidelines, and eligible patients may not receive it.
  • The streamlined IPU pro forma showed potential but requires further refinement to improve guideline adherence and completion rates.
  • Complementary strategies are needed to enhance compliance and optimize palivizumab's effectiveness in preventing severe RSV disease.
Abstract

Keywords:
general paediatricsinfectious diseaseneonatologyrespiratory

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