[Chemoprophylaxis with palivizumab in Andalusia (Spain). Results of the 2000-2001 respiratory syncytial virus epidemic].
OBJECTIVE
To assess the hospitalization rate for bronchiolitis in newborns treated with palivizumab in Andalusia.


METHODS
We performed a prospective study of 283 neonates and infants who received prophylaxis with palivizumab in Andalusia during the 2000-2001 bronchiolitis epidemic. We also performed a descriptive study of hospitalization for bronchiolitis, classifying patients according to gestational age and whether they had bronchopulmonary dysplasia (BPD).


RESULTS
Most (86.9 %) of the treated patients were born before week 32 of gestation (63 % before week 30) and 38.4 % developed BPD. A total of 10.6 % of palivizumab-treated newborns were hospitalized for bronchiolitis, of which 3.9 % was caused by respiratory syncytial virus (RSV) (4.8 % of patients with BDP and 3.5 % of those without BPD were RSV-positive). Compared with preterm neonates born in weeks 31 or 32 of gestation, palivizumab-treated newborns born before week 31 showed a higher hospitalization rate for bronchiolitis (13.3 % vs 6.3 %; p < 0.05) and that for RSV was three times higher (5.0 % vs 1.6 %; p < 0.05). Age at admission was 5.8 3.2 months. Length of hospital stay was shorter in RSV-positive patients with bronchiolitis (6.7 vs 7.6 days; p > 0.10). Admission to the intensive care unit was required in 0.7 % of patients and in 50 % of those who were RSV-positive. Adverse effects were observed in 5.1 % of palivizumab-treated patients.


CONCLUSIONS
The marked differences in the perinatal antecedents of patients receiving immunoprophylaxis may explain the variations in the efficacy of palivizumab reported in available studies.
D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001990:Bronchiolitis, Viral / Q000517:prevention & control*; D001997:Bronchopulmonary Dysplasia / Q000150:complications; D004196:Disease Outbreaks / Q000517:prevention & control*; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D000069455:Palivizumab; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000517:prevention & control*; D013030:Spain
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab
Quimioprofilaxis con palivizumab en Andalucía. Resultados de la epidemia de VRS 2000-2001.