Evaluating national guidelines for the prophylactic treatment of respiratory syncytial virus in children with congenital heart disease.
OBJECTIVE
This is the first study to evaluate compliance with the 2003 Swedish national guidelines for prophylactic treatment of respiratory syncytial virus (RSV) in children with congenital heart disease (CHD). We estimated the relative risk (RR) of children with CHD being hospitalised with a RSV infection, studied the extent to which RSV prophylactic treatment with palivizumab corresponded to the guidelines and determined the morbidity of children with CHD who developed RSV infection despite prophylaxis.


METHODS
This national observational study comprised prospectively registered data on 219 children with CHD treated with palivizumab, medical records on RSV cases and information on hospitalisation rates of children with CHD and RSV infection.


RESULTS
The calculated RR of children with CHD being hospitalised with RSV infection was 2.06 (95% CI 1.6-2.6; p < 0.0001) compared with children without CHD. Approximately half of the patients (49%) born before the RSV season and 25% born during the RSV season did not start treatment as recommended by the guidelines.


CONCLUSIONS
Having CHD increased the rate and estimated RR of children being hospitalised with RSV infection. The guidelines were not followed for about half of the children born before a RSV season and a quarter of the children born during a RSV season and need updating.
Department of Clinical Science, Paediatrics, Umeå University, Umeå, Sweden.
Elin
E
Granbom
Eva
E
Fernlund
Jan
J
Sunnegårdh
Bo
B
Lundell
Estelle
E
Naumburg
D019072:Antibiotic Prophylaxis; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D000069455:Palivizumab; D017410:Practice Guidelines as Topic; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology
D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab
Congenital heart disease; Palivizumab; Prophylaxis; Respiratory syncytial virus; Swedish national guidelines