Respiratory Syncytial Virus Hospital Admission And Outcome In Ireland Among Infants Born Less Than 32 Weeks Gestation In The Era Of Changing Palivizumab Prescription Guidelines

Background Mortality and morbidity among children with Respiratory Syncytial Virus (RSV) bronchiolitis is higher among infants born prematurely and those with chronic lung or congenital heart disease. Palivizumab is a monoclonal antibody that provides passive immunity to RSV and can modify the disease course in high-risk infants. In 2006, the American Academy of Paediatrics published a clinical practice guideline recommending that infants born less than 32-weeks gestation receive Palivizumab if aged less than twelve months at the start of the RSV season. An updated guideline in 2014 however, advised that only infants less than 29-weeks should receive Palivizumab in the absence of other indications. The aim of this study was to determine the impact of changing guidelines on RSV-related hospital admissions, management and outcome among infants born Methods Data was collected prospectively for all patients admitted with RSV bronchiolitis from 2004–2017 at a tertiary paediatric hospital. The two groups of interest were infants born Results There were 2851 admissions with RSV-bronchiolitis during the study period. There were 39 infants Conclusion The 2014 updated AAP-guidelines on Palivizumab use has been associated with reduced prescription in the 29–32 week gestation group. This change has not resulted in increased frequency of hospital admission or PICU admission among infants