Recent developments in pediatric respiratory syncytial virus prevention: The expanding role of monoclonal antibodies

This article provides a concise evaluation of the monoclonal antibodies that have received regulatory approval for prevention of respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) in certain pediatric groups, with an emphasis on key considerations for pharmacists to aid in clinical decision-making, medication access, and patient education.

RSV monoclonal antibodies have emerged as a critical preventative strategy, particularly in infants and young children. For over 25 years, palivizumab was administered in select pediatric populations; however, it is no longer preferred due to the improved efficacy, duration of protection, and convenience of administration of newer agents. The recently FDA-labeled monoclonal antibodies nirsevimab and clesrovimab demonstrate strong efficacy in preventing RSV LRTD and have favorable safety profiles. Regulatory approval and guidance from national health authorities continue to shape the appropriate use of these therapies across different patient groups.

The utility of RSV monoclonal antibodies continues to evolve, with these antibodies offering promising targeted, durable protection against a virus that remains a major cause of morbidity in infants and young children. Ongoing surveillance, real-world evidence, and continued innovation will further refine the role of these agents in clinical practice. Pharmacists play a pivotal role in evaluating appropriate candidates for therapy, navigating payor and formulary requirements, and educating caregivers and healthcare teams on administration, storage, and monitoring.