Eligibility for palivizumab prophylaxis in a cohort of children with severe bronchiolitis.
In 2014, the American Academy of Pediatrics (AAP) updated their recommendations for palivizumab prophylaxis for children who are at high risk for severe respiratory syncytial virus (RSV) infection. To investigate the potential impact of the more restrictive 2014 criteria on the eligibility for palivizumab prophylaxis, we applied the 2012 and 2014 AAP recommendations for palivizumab prophylaxis to a multicenter cohort of 2207 US children hospitalized for bronchiolitis. According to the 2012 AAP recommendations, 215 children (9.7%) were eligible for palivizumab prophylaxis, while 140 children (6.3%) would have been eligible based on the 2014 updated recommendations (34.9% relative decrease; 95%CI: 28.5-41.7%). The decrease was largely driven by the restriction of eligibility to preterm infants with gestational age <29 weeks. Further development of and refinement of cost-effective approaches for the prevention of severe RSV infection are needed.
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Kohei
http://orcid.org/0000-0002-5739-7999
K
Hasegawa
Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Jonathan M
JM
Mansbach
Departments of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, Texas.
Pedro A
PA
Piedra
Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Michelle B
MB
Dunn
Department of Emergency Medicine, Weill Cornell Medical College, New York, New York, USA.
Sunday
S
Clark
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Ashley F
AF
Sullivan
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Carlos A
CA
Camargo
D000998:Antiviral Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D000069455:Palivizumab / Q000627:therapeutic use*; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000998:Antiviral Agents; D000069455:Palivizumab
bronchiolitis; eligibility; guideline; palivizumab; prophylaxis