title: Infants born before 32 weeks of gestation or with respiratory disease are most likely to receive palivizumab in the Netherlands.
abstract: OBJECTIVE
  Palivizumab is reported to be effective in reducing respiratory syncytial virus hospitalisation. Its licensed uses include infants younger than six months of age, born before 35 weeks of gestation or under two years old with congenital heart disease or bronchopulmonary dysplasia. We redressed lack of research in the Netherlands by studying whether infants who met the licensed indications received the drug.
  
  
  METHODS
  Data were obtained from the PHARMO Database Network and The Netherlands Perinatal Registry for all linked infants born between 1 April 1999 and 31 March 2007. Determinants for receiving palivizumab were examined using logistic regression analyses.
  
  
  RESULTS
  Only 15% of the 3321 infants who met the licensed indications received palivizumab and the strongest predictor was being born before 32 weeks of gestation, with an odds ratio of 49.1 (95% confidence interval 31.5-76.4). However, 50% of infants born before 32 weeks did not receive palivizumab and the subanalyses showed that the probability increased for infants born in later years, those who had respiratory distress syndrome and those hospitalised during the respiratory syncytial virus season.
  
  
  CONCLUSIONS
  Only 15% of eligible infants in the Netherlands received palivizumab and they were mostly born before 32 weeks, in line with Dutch guidelines.
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: Leanne M A
authors.initials: LM
authors.lastname: Kool-Houweling
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: Fernie J A
authors.initials: FJ
authors.lastname: Penning-van Beest
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: Irene D
authors.initials: ID
authors.lastname: Bezemer
authors.affiliation: Department of Neonatology Isala Clinics, Princess Amalia Department of Pediatrics, Zwolle, the Netherlands.
authors.forename: Richard A
authors.initials: RA
authors.lastname: van Lingen
authors.affiliation: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors.forename: Ron M C
authors.initials: RM
authors.lastname: Herings
mesh_terms: D000367:Age Factors; D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D009426:Netherlands; D000069455:Palivizumab / Q000627:therapeutic use*; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D000069455:Palivizumab
keywords: Determinants; Observational database study; Palivizumab; Prematurity; Respiratory syncytial virus